Student nurse confused about suctioning

[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.

[turnforthenurse, MSN, NP]

I was always taught continuous. Just don't apply the suction when you're going down into the airway....

[zumalong]

Know your agency's policy, but I have never seen suctioning resp. secretions as intermittent unless it is pt. who can give you good airway clearance. The more important aspect should be length of time suctioning and need for supplemental O2. with many of our resp. compromised pts we give high flo O2 before and after suctioning.

[canned_bread]

Throughout nursing you are going to encounter these sort of dilemma's all the time. There is always different ways of doing different things. The important thing is evidence based practice and a rationale you can verbally say and also write to back you up and you will be fine!