bolusing a trach with ns but not suctioning afterwards

[Happiness08]

has anyone ever heard of bolusing a trach with NS but not suctioning afterwards? it seem to me that this is more harmful than benefical.

[iwanna]

From my own personal experience, the bolus of ns for thick secretions, plugs have been very relieving, and followed by gentle suctioning. I have had two trachs in the past. I guess it depends on the pt. The bolus of ns would burn if the secretions are not that thick. I have never heard of a coughalator. Please explain it to me.

[bethem]

Wouldn't a NS neb be more comfortable and equally effective? It seems so counter-intuitive to stick water in someone's lungs on purpose.

Especially if you don't then suck it out again.

[Pipsqueak, ADN]

I do it sometimes. I usually sx first without the NSS, but if the secretions are beyond the lenght of the trach, adding just a few gtts of NSS will induce a cough and results in the airway being cleared on its own. But I still follow by suctioning to make sure all the secretions are removed.

I have seen some nurses chart, "NSS gtts instilled for dryness". Never got a chance to ask them what they meant by that or how it could even be effective in decreasing "dryness". I agree with the poster that said a NS neb or trach mask attached to a humidification system would be more effective in that case.

FYI: A coughalator is basically this air compressor type thing with tubing that attaches directly to the trach. It gives an inhalation at a preset pressure, followed by a quick exhalation also at a set pressure. It's used to mimic a cough in pts that are unable to do so on their own. Hope I explained that right.

ETA: I work with pts who are trached long term. Don't think I would do this for fresh trach pts in a hospital.

[ventgurl, ASN]

yes, its called "lavaging". This is usually done by a Respiratory Therapist. Hyperoxygenating the patient before the procedure usually decreases the chances of hypoxia.

[jstbreathe]

We do all the time. Esp on thick secretions. We also use iso Hc03, ambu bag in for 1 min, then sx. Sounds awful, I know. But helps with thick secretions. Stops plugs!

I wouldn't want it done to me, but I know it works!!