ICU Suctioning equipment

[PupTheNurse]

Hi there,

I'm a new member here at allnurses.com but I've been reading threads for years. I'm an RN trained in Europe and I have a masters degree in critical care nursing. I'm currently working in the neurological ICU.

I'm writing a piece on airway suctioning mainly focusing on hygiene and flushing/storing procedures.

I was hoping someone on here could tell me what the procedures are in North America and if there is an official guideline and if so where I can find it.

In Sweden we have a separate rinsing canister (open top) with tap water in it to flush the line once you're done suctioning the airway. We also always store the line tip up.

I'd be super greatful for any information on the subject!

[AnthonyD]

Are you talking about nasotracheal suction? Endotracheal tubes? Tracheostomy?

Ventilated or non-ventilated patients?

[PupTheNurse]

Anthony,

The flushing and storing procedure is the same here regarding all of the above. Do you have different procedures for rinsing and storing depending on the type of artificial airway where you're at?

[AnthonyD]

Yes, we use closed suction for ventilated patients - both trached and intubated, using Ballard suction.

For non-vented trach patients, we use a single-use suction catheter with a single-use bottle of normal saline, and it's a sterile procedure.

NT suction is essentially done the same as trach suctioning - it's only done with single-use equipment. We don't rinse or re-use any of it.

[Guest805836]

(I'm in France)

We use closed suction equipment exclusively for ARDS patients, in order to avoid 'de-recruiting' collapsed lung areas (I'm sorry, my medical english is approximate, I hope I'm being clear).

For the other reasons patients may end up vented, my facility doesn't see the necessity for closed suction, so we use single use suction catheters, which are rinsed with sterile water (changed daily, and the cath in the bottle is clean, we do not put the used catherer in the bottle obviously).

The manipulations are done with not sterile gloves / mask / possibly with eye guards if patient is likely to have sputum fly around on uncapping the orotracheal tube, the suction cath is manipulated using sterile compresses and sterile lubricating spray.

[Greenclip]

In my hospital we do exactly the same as Anthony, above. All ventilated patients have an in-line Ballard suction, and for non-vented trach patients, it's a sterile procedure with single-use equipment.

In out-of-hospital situations, it is usually different. For example, in rehab facilities or nursing homes, trached patients are suctioned using a clean procedure such as you describe.