Can distilled water be used for suctioning trachs?

[Blackcat99]

I use the pink bullets of sodium chloride to suction the trach now. However, it seems we are always low on these sodium chloride bullet supplies and the company won't send more supplies until the due date. Mom won't pay out of pocket for any supplies. I was just curious if I could use distilled water if we were completely out of supplies? I was thinking I could keep a bottle of distilled water if possible in my car to use in case of no supplies. Thanks.

[Blackcat99]

Thanks all so very much for your advice and NS recipes. Yes, I will check into it and maybe make myself some normal saline for emergencies.

[Blackcat99]

Update: I have started a new 2nd job now. I asked the nurse at the home, "Where is the normal saline for suctioning the trach?" She showed me two large cups. I asked her what was inside the two large cups and she said "tap water". I asked her a 2nd time about it because I couldn't believe it. She said "Fill these cups with tap water. We don't use normal saline here. We use tap water for suctioning the trach.":eek:

[CloudySue]

They use tap water where I work also. After working an LTC for so long, sometimes it's still hard for me to wrap my brain around the different standards for procedures and protocol. The risk of nosocomial infections is nearly a non-issue in a private home, plus families may not be financially able to replace supplies as frequently as a facility would. I feel better bc in a facility I'd constantly be bothered by all the waste, especially the non-recycled plastic.

[nursel56]

You mean they use tap water to instill in the trach for lavage? Yeesh! We use clean cups and clean non-sterile water to rinse through the suction catheters and the Yankauers, though. I haven't yet had a family that used a brand new sterile suction catheter for each suctioning. As for the disposable plastics, I don't like them! I like the old school vent tubing - it's sturdier, easier to work with (not as stiff so easier to get patient comfortable). They last a long time if properly cared for.

[Blackcat99]

Thanks CloudySue and nursel56. OK. So I am not alone. They also use tap water at your job too. Yes, they use tap water to install in the trach for lavage. They use what looks like an orange foley catheter for suctioning. I haven't suctioned this child yet so that will be something new for me to try. The nurse said I suction the trach first, then the mouth and then the nose and then throw away the orange suction catheter.

[CloudySue]

No, just tap water for cleansing out the tube between suctions, is what I meant.

[systoly]

What type of catheter are you using and are you talking about saline for cleaning the catheter or saline for thinning secretions? If you need the saline to thin secretions, perhaps humidification is an option. Is the patient on fluid restriction?

[scrubsz]

NEVER ever-ever use tap water to lavage a trach! Tap water contained so many impurities, including gobs of chlorine, minerals, and particle of copper from the pipe sin your house. Use tap water, and your bound to set those lungs up for an infection.

This goes the same for humidifiers for BiPAP, CPAP, ventilators and even room humidifiers.

As far as using sterile or distilled water, water is more irritating to the airways and can cause lots of coughing compared to the normal saline. So always try to stick with saline if possible.

Trachs should be suctioned PRN (when ever needed), never at time intervals. Why suction the trach if it doesnt need to be. Same goes for installation of NS. Use it if you think secretions are becoming more tenatious. If they remain nice and loose, then forgo it.

In the hospital, we RARELY if ever use saline when suctioning trachs. Its actually been proven that using NS during suctioning DOES NOT improve the mobilization of secretion removal. What does work, it adequate humidification. Wearing a trach collar with humidified air/gas at 37' celcius (98' degrees) is plenty enough to make sure secretions are mobile. Remember, a tracheostomy bypasses the upper airway, and the purpose of the upper airway is to WARM, HUMIDIFY, and FILTER the air we breath.

All of these humidification devices are not portable however. We do use Heat Moisture Exchangers (HME's). They are either adaptors that fit on the end of the trach itself, or patches that lay over open stomas. They catch the moisture upon exhalation, trap it, so that the moisture can be re-breathed in.

[smartnurse1982]

This is interesting.

We have orders to use sterile water for cleaning the catheters after use with just about all cases.

The only ones i know who use saline bullets are the ones who have in-line suction catheters(and on vents).

Regarding humidification,i have rarely seen a trach and vent patient without it.

Most have heated humidification,although lately,many kids have had the heated humidification taken away and replaced with room temp humidification.

Many vent/trach kids do not tolerate the heat well.