NATIONAL SURVEY OF ENDOTRACHEAL SUCTIONING TECHNIQUES IN THE PEDIATRIC POPULATION

OBJECTIVE: To examine the current suctioning practices nationally of e xperienced pediatric intensive care unit (PICU) nurses. DESIGN: A writ ten survey method was used for this descriptive study. POPULATION: All PICUs in the 92 hospitals listed in the 1991 National Association of Children's Hospitals and Related Institutions directory. PARTICIPANTS: Staff nurses with more than 3 years experience were requested to comp lete the questionnaire in relation to their endotracheal suctioning pr actices of PICU patients. RESULTS: The questionnaire was returned by 8 0 (90%) PICUs. A wide range of suctioning techniques were used. Most r espondents reported hyperoxygenation, hyperventilation, and/or hyperin flation of the patient's respiratory system before suctioning. Nursing judgment and the patient's clinical condition were used to determine when a suctioning procedure was needed. Most respondents (71%) indicat ed inserting the suction catheter until resistance was met. Normal sal ine-solution irrigant was used by all but one respondent. A manual res uscitation bag was used routinely during suctioning. Eighty percent of respondents reported that few patients displayed an adverse response to the suctioning procedure.RECOMMENDATIONS: The study should be repli cated with direct observations of actual PICU suctioning practices. Su ctioning techniques should be examined in relation to specific groups of PICU patients. Further research is needed to determine the optimal practice for rates of hyperventilation, percentage of oxygen increase during hyperoxygenation, and pressure increase during hyperinflation.