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Discussion

HELPFUL opinion needed!!

if THERE have pt with respiratory failure who has an endotracheal tube and requires suctioning q 1-2 hrs, & every time pt suctioned the mucus is thick, streaked with blood & pts hr increases by abt 40 bpm and o2 sat deops from abt 97 to 90.i know i should be concerned, but exactly why, besides the fact the pts tube may be suctioning pts actual membranes, and what is a priority intervention I CAN DO to prevent this from happening?

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If I am reading your post correctly your saying that you have a intubated patient with thick blood streaked secretions who requires frequent suction to maintain tube patency.

On suction the patient becomes a bit more tachy and desats, and you want to know why and what you can do to prevent this?

If this is correct then any suction is traumatic and is simulating a cough reflex in patients who are unable to clear thier own secretions. It is unpleasent for the patient which may account for the increase in heart rate additionally don't forget that by suctioning you are interfering with the respiratory function which would cause a desat. To be honest I wouldnt worry too much about a drop to 90 any further I would consider maybe pre-oxygenation.

Is this patient ventilated and are you using a closed suction system?

Now, I'm a new grad, but I thought you were supposed to hyper-oxygenate a pt. before suctioning them b/c they will desat. Am I correct or not?

It sounds like the patient is losing too much oxygen during the suctioning i.e. hypoxia causes tachycardia and decreased O2 sats; either the patient needs to be hyperoxygenated more before suctioning or maybe you are suctioning for too long (should be

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I think pre-oxygenation depends on where you work. The units I have worked on in the UK 2 have pre-oxygenated and 1 assessed the patients, if they had low O2 requirements and good sats then we didn't if they had high ventilation reqs and poor oxygenation we would.

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