bolusing a trach with ns but not suctioning afterwards

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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.

Specializes in behavioral health.

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.

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Specializes in Med onc, med, surg, now in ICU!.

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.

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Specializes in Homecare Peds, ICU, Trauma, CVICU.

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.

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Specializes in CTICU.

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

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Specializes in ER, ICU,.

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!!

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