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.