Evidence-based suction management in Accident and Emergency: a vital component of airway care

Development of standard practice guidelines for open and closed system suctioning

“…This finding is important in that it indicates that all of the nurses realised the importance of doing the procedure in <10 seconds and acted accordingly. If the suctioning procedure lasts longer than 10 seconds, oxygenated air may be aspirated from the airway along with the secretions, leading to hypoxia (Dean 1997, Wood 1998a, McKillop 2004). Çelik and Elbaş (2000) stated that the duration of moving and removing the catheter from the endotracheal tube should be 40 seconds at most.…”

“…Another factor that can cause hypoxia is not giving the patients enough time to rest between repeated suctioning (Doğar 1992, Dean 1997, Wood 1998a, McKillop 2004). For the standard open and closed suctioning methods, although the proportion of nurses giving the patient sufficient rest was initially low, all nurses allowed the patients to rest for 20–30 seconds during the third observation.…”

“…Unnecessary suctioning may lead to the waste of expensive resources and the appearance of complications. On the other hand, being unaware of the symptoms of the need for suctioning and not doing what is necessary for the patient may lead to dangerous consequences (Glass & Grap 1995, Dean 1997, Wood 1998a. Czarnik et al (1991) emphasised that avoiding routine suctioning every hour and limiting the amount of suctioning as far as possible are important for preventing untoward trauma to the trachea.…”

“…Data of this study were collected by using the Questionnaire on Knowledge Levels Regarding Open and Closed System Suctioning, Standard Open System Suctioning Nurse Observation Form and Standard Closed System Suctioning Nurse Observation Form. The questionnaire was developed based on the literature (AARC 1992, Dean 1997, Wood 1998a,b, Çelik & Elbaş 2000, Day et al. 2001, 2002, Berman et al.…”

“…The nurses who participated in the investigation were offered four hours of training (three hours theoretical and one hour practical) on the methods of open and closed suctioning at Hacettepe University Nursing School from 6–24 February 2006. During the training, educational material was prepared in parallel with data obtained from the questionnaire and the literature (AARC 1992, Dean 1997, Blackwood 1998, Wood 1998a,b, Çelik & Elbaş 2000, Day et al. 2001, 2002, Pruitt 2005).…”