suctioning the intubated pt...1 nurse/RT, or 2? - page 2

by kessadawn

5,888 Views | 12 Comments

recent topic of discussion in my picu... when you have an intubated patient, regardless of level of sedation, ease of the intubation, vent settings, etc., what is your picu's policy on suctioning, do you do it yourself, or... Read More


  1. 1
    Quote from tigkaskit
    (Trachs are easier to connect the bag to when you're bagging 1-handed.)
    Hi
    Iīm sorry if this is a dumb question, but why are you bagging when you are suctioning. When do you do it (before / after)?

    Iīm a nicu nurse here in sweden and we never use bagging in conection to suctioning, but maybe itīs different with older children?

    We try to use two persons for suctioning (except in extreme emergencies) simply because it cuts down the time the baby is without his/her ventilator. It also gives an extra set of hands to calm and support the baby. We donīt use RTīs here so itīs usually two nurses doing it. We donīt use in-suctioning in my unit and we only use clean gloves (not sterile) and then keep the catheter sterile.

    Anna
    kessadawn likes this.
  2. 1
    Quote from Sweden
    Hi
    Iīm sorry if this is a dumb question, but why are you bagging when you are suctioning. When do you do it (before / after)?

    Iīm a nicu nurse here in sweden and we never use bagging in connection to suctioning, but maybe itīs different with older children?

    We try to use two persons for suctioning (except in extreme emergencies) simply because it cuts down the time the baby is without his/her ventilator. It also gives an extra set of hands to calm and support the baby. We donīt use RTīs here so itīs usually two nurses doing it. We donīt use in-suctioning in my unit and we only use clean gloves (not sterile) and then keep the catheter sterile.

    Anna
    Hi Anna,

    Bagging during suctioning is needed to maintain adequate arterial oxygenation levels and to maintain adequate lung volumes, especially for those patients who require a high PEEP. All of which, if lost, can induce hypoxia. Since you don't use in-line suction catheters on your unit, bagging will help those babies maintain good lung volumes while off the vent. It'll cut down even more time away from their needed pressures and oxygen as you were already doing.

    -T
    kessadawn likes this.
  3. 1
    It depends on the pt and availability of extra hands. On pts who are unstable I always get that extra set of hands. For a sedated pt, I give sedation before I suction, then I suction by myself. It was hard to do at first but now I am comfortable with it. I had a pt on the oscillator who needed to have suctioning off the vent, obvioulsy two person suctioning (even though there was an inline, we needed to go much deeper). I even asked for the doc to stand by in case the pt crashed. Thankfully only slight decompensation. also, my neighbor nurse was aware and also on standby.
    kessadawn likes this.


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