is it that bad???

[registeredin06]

I often use the same suction tubing for the inline suctioning of an ETT as well as for the yankeur. I remove the suction from the inline tubing and attached to the yankeur periodically when oral suction is needed, then reattach the suction to the inline tubing and put the yankeur back in the package tucked under my pt.'s pillow. I was taught this way and was under the impression that the inline tubing had a one way valve so as to prevent bacteria from climbimg in. I recently had a nurse correct me and said "noway would she ever do this" and that seperate suction tubing must be provided for these two devices. How does everyone else do it?? I feel awful that I have jeopardized pt. safety.

[MissAnthrope]

Seems to me that using same tubing for the inline suction and the oral suction would be risking cross contamination. Oral suction = nonsterile environment with eleventy billion germs, and ETT suction = sterile environment. Germs could probably travel down that highway into the ETT and therefore the lungs. And the less you interrupt that closed system (In-line ETT suction) the better, and less chance of VAP. With CMS no longer going to pay for VAP (I believe), this is a big deal in hospitals now.

We have the splitter also, same receptacle, different tubings.

[PiPhi2004]

I have done it both ways as our hosp has no written protocol for how to do this. But I hate to leave the ET tube off to suction ever because if something goes wrong and I cant find the tubing and I need to suction, I'm in trouble. If I'm short on canisters and cant hook up an oral, I remove the suctioning from the ET tube and do oral, and switch it back right after, therefore I dont have to worry about trying to suction with no suction lol. Usually with admissions we set up two different setups though, because personally I find it easier to always have suctioning handy for the conscious pt that can oral suction themselves, and one for the vent. I am sure that VAP would be a good reason to NOT switch back and forth, thanks for bringing that argument to the table. Food for thought!

[SWEnfermera]

Every hospital should by now have a VAP Prevention protocol in place. Oral care should be done at minimum of every 4 hours, with a dedicated suction line for oral care. The Yaunker should be covered when not in use. My hospital has purchased the oral care products from Sage. I like it because each kit lasts 24 hours. If someone misses doing oral care, you'll know because there will be items remaining from the kit.

Here are the Practice Alerts issued from AACN on oral care:

http://www.aacn.org/WD/Practice/Docs/Oral_Care_in_the_Critically_Ill.pdf

http://www.aacn.org/WD/Practice/Docs/Ventilator_Associated_Pneumonia_1-2008.pdf

Here is info on the Sage products:

http://www.sageproducts.com/products/video.cfm?video=thumbPort&script=thumbPort.htm

[ghillbert, MSN, NP]

We don't even use inline suction, and we use the same tubing for ETT and NP/OP suctioning. ETT first w/sterile technique, then the same catheter (8 or 6Fr, talking babies here) for the NP and OP. Catheter removed, tubing hooked through the isolette or around the bars of the crib. Sounds gross, but we have very little VAP to speak of. Tubing is changed q24 and PRN, and canisters just PRN.

Settle down there, registerdin2006 - I was responding to the poster before me, who clearly mentioned babies, as well as saying "the same catheter for the NP and OP".

[registeredin06]

Oh, I'm so sorry, I was "settled". I guess it is difficult sometimes to read someone's emotions without the verbal expressions and body language!! No worry, I don't get too excited on a discussion f:Drum.