ET Tube suction.

Specialties NICU

Published

Hello. I'm really new to neonates and I'm loving it so far. My main concern is I'm underconfident when it comes to suctioning a Et tube.

I know how to do it, but I struggle with when to do it, if I should use saline, how many times I should do go down etc. I ask for help every time I need to suction a baby but our unit is really busy and at times no one is available. I'm also aware that the more I ask for help, the more I'm finding myself never wanting to do it on my own.

Does anyone know of any resources online that are helpful in this topic?

We use saline for thick and difficult to suction secretions despite being well aware that the evidence is inconclusive. I think the reason we are still willing to do it is because clinically, we see results from it. I am unsure about this practice however this is what more senior nurses think on our unit.

Suctioning is touchy and being gentle and nervous is a good quality honestly. If your suction catheters do not have millimeters/centimeters marked on them and/or your ETTs don't have measurements on them either then I would recommend suggesting this.

In adults suctioning is pretty cave-man. Jam it in there until you meet resistance, suction on the way out.

In Neonates suctioning can be pretty touchy. Make sure your suction pressure is low enough (I think 80cmH2O is the recommendation)

Be gentle, advance the catheter in and "line up" your measurement lines, and then suction on the way out. Slower (in my experience) is better because I can do a single pass and not risk destroying their FRC repeatedly where I'd have to make multiple passes if I went fast. If I don't get anything, I don't do another pass. If I get giant "Boogz" as I like to call secretions, I will do another pass.

I assess for suctioning Q1 to Q3 but I typically actually suction Q6-Q12, I don't routine suction and we do not allow routine suction orders by providers (MD/NPs)

I almost never, ever use saline for anything except purging the suction catheter. I cannot remember the last time I lavaged with saline during a suction.

I tried to find an online education thing but all I can find are bedside sheets to to write down depths for the bedside from the companies that make the in-line catheters.

Specializes in medical.

All your comments have been really intersting and helpful. Honestly it's so good to get people's insight into suction practice in different units. I feel more confident now with it, although I'll still be asking someone to stand by me until I feel ready to do it on my own.

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