[JSouba]

I'm a student nurse in my second semester of school, and I'm a little stumped on continuous versus intermittent suctioning. I was taught to always use intermittent in class, and the nurses on my unit say to use intermittent, because it decreases the risk of damaging the airway. However, when I used intermittent suctioning in front of a respiratory therapist, she told me to always use continuous because it's more effective, and every other respiratory therapist I've talked to agrees.

So, now I have to change my method depending on who is watching me!

I've found two articles on the topic (references below). Glass and Grap say to use continuous, as there's no evidence that intermittent reduces trauma. Czarnik et al. found that both methods were equally damaging to the airways of dog, but they were using suction pressures of 200 mmHg...

What do you think? Which do you use, and why? Have you found one to be more effective/damaging?

I'm going to write a paper on this for my theory class, so I'd love to get as many opinions as possible!

Thank you!

Glass, C., & Grap, M. (1995). Ten tips for safe suctioning. American Journal of Nursing, 5(5), 51-53.

Czarnik, R., Stone K., Everhart, Jr. C., and Preusser, B. (1991). Different effects of continuous versus intermittent suction on tracheal tissue. Heart and Lung, 20(2), 144-151.

[outlierrn]

Back in one of my other lives I observed that you could ask two farmers about the best way to cultivate tomatos, get two diametrically opposed answers, get reasonable, rational explanations for each, and damned if you could tell them apart come harvest. Try not to let it nut you up.

[Tweety]

I've never thought of that. I learned to suction using continuous.

I guess it depends on if the patient has a good cough. If they have an effective cough then intermittant would probably be o.k. But if not (which is usually why we suction in the first place), I would think intermittant would leave some residual sputum and cause the need to suction more, which would negate any benefit of trauma to the patient.

What source did your instructors use when you learned to suction intermittant?

[JSouba]

I'm not sure if they have a source. I think they're teaching what they do- how they were taught. I asked one of them about the respiratory therapist's advice, and she said that respiratory was probably just more concerned about effectiveness, while the nurse worried about patient saftey.

The textbooks I have talk about the issue as a debate, they don't give solid instructions, which is why I want more opinions!

[graysonret]

I was always taught continuous suctioning. I agree that intermittent suctioning would be cause for more work, and more damage to the patient. Insert catheter to proper depth, begin suctioning as you slowly withdraw it, twirling it as you go. Don't forget to hold your breath, since the patient can't breathe. That way you know when to stop.