Closed suction systems

BittyBabyGrower, MSN, RN · Jan 19, 2005

Yes we do. It is now in our standard of care. We do have the occasional kid that doesn't tolerate them and needs 2 man, but we have to have an attendings order to dc the Neolink and catheter.

We use them on all our nitrics and osc/HFV kids. It is great not to have to break the line :)

fergus51 · Jan 19, 2005

Not on the unit I currently work on. The staff trialed them and don't like them and claim they just don't work. My previous unit used them and we all loved them, especially for kids on PPHN precautions, oscillators, jets and NO.

KaliRyan · Jan 19, 2005

Yes we use them on all the kiddos. I've never ever seen the 2 man method. Of course I am brand spanking new to NICU. Seems to work for us.

nekhismom · Jan 19, 2005

We do not use in-line suction on any kid under 1200 gms, regardless of what type of vent they are on. We do not use in-line suction on ANY kid on a jet vent, and don't use oscillators. Wish we did, though. In-line is a whole lot easier than manual suctioning. I'm just now learning how to remain sterile with one hand and bag with the other. Takes lots of practice!

kitty29 · Jan 19, 2005

Hi everyone!
Do you use the closed suction systems on your units?
Do you use them when the baby is on occilator or Nitride oxide?
Thanks iceNICUnurse.

Yes.

dawngloves, BSN, RN · Jan 19, 2005

Hi Ice! Long time no see!

We use closed with oscillators. Sometimes if the kid is on a conventional vent and has a lot of secretions and needs frequent suctioning.

I have to say, I don't like to use it if the secretions are thick. Doesn't seem to work as well.

iceNICUnurse · Jan 20, 2005

Thanks so much for your replies

We are thinking of starting to use this in my unit but some are a little worried that it does not work well for the sickest kids. People are afraid of air trappement or something like that on HFV. Has that ever happend that you know about?

We have not been able to find any litterature on this exept for using it on preemies on conventional ventilators.

Is there some product that is better than another?

Thanks so much

iceNICUnurse

Gompers, BSN, RN · Jan 20, 2005

People are afraid of air trappement or something like that on HFV. Has that ever happend that you know about?

Our respiratory therapists shut off the oscillator for the 3-4 seconds it takes to inline suction a baby. If they need to make another pass, they give the baby a minute or so to recover, then shut it off and go down again. They say it prevents air trapping, and that they get much more sectretions because they're not "fighting" the oscillator during the suctioning. The kids generally do okay afterwards, but this is why we only suction HFOV kids on a PRN basis (usually only about q12-24h).

For the tiny babies, they really want us using inline instead of 2-man because they don't want us bagging kids if we don't have to, because the pressure isn't as regulated as it is on the vent. They want to reduce as much trauma to the micropreemies' lungs as possible. The kids tend to do pretty well (maybe a quick brady or desat) because instead of taking them off the vent or bag to go down and suction, they are constantly getting breaths from the vent so they recover without needing major bagging or increased oxygen.

We love them!

prmenrs, RN · Jan 20, 2005

When we were first trying the device, we used it on babies that didn't tolerate any change in mean airway pressure. With the in-line suction, you don't lose any airway pressure. They are getting to be standard of care because of less contamination.

Tiki_Torch · Jan 20, 2005

We use them on all our babies and change them every 24 hours. I believe the company is named Ballard. At my previous NICU we did the two-person suction with the saline drops and all that. From my experience with these in-line suction catheters I've noticed the babies tolerated suctioning much better and it's a real plus not having to have another nurse come to help you. Sure, it can be done alone, but the chances of contamination and bagging with inappropriate pressures is much greater than with two people.

We recently viewed a Sensorimedics video from the company concerning the oscillator and it said to suction only prn. It makes since because the oscillator is constantly pushing air and secretions too I suppose out to the periphery. I have seen this to be true because babies on oscillators usually have scant secretions until they come off the oscillator and go to a conventional vent which is when we see lots more secretions.

I'm a fan of in-line suction catheters.

Tiki

sparkyRN · Jan 20, 2005

They're growing on me too.

When we first tried them 10 or so years ago they just didn't seem to work very well. I believe we also use Ballard now, BUT we are limited to using them on the fragile babies-micropremies, oscillator and nitric--it's a money thing. And really, if it's a big mec. asp. baby most of us still would prefer traditional suctioning to get those plugs out. We don't have RT and are all skilled on one person suctioning.