Normal Saline Usage and Pneumonia

Paper Summary:

This paper assesses the issue concerning whether or not to use normal saline during suctioning, and most especially when the patient is an infant or a very weak and compromised adult. However, this question does not deter nurses and other medical practitioners from using the normal saline technique for suctioning, and the practice is still widely used. Furthermore, the paper looks into the issue of whether this procedure actually helps the patient, or if it is unnecessary. Specifically, the paper discusses the prevalence, the benefits and disadvantages, the purposes of using the procedure and the risks and negative consequences of using normal saline for suctioning purposes. Lastly, the paper looks at one specific illness associated with the procedure, called ventilator assisted pneumonia.

From the Paper:

"A Survey was conducted a few years previously, on a number of nurses and medical practitioners who were working in adult ICU's in a large teaching hospital facility, in order to make an accurate and clear assessment of the advantages and the disadvantages of using normal saline during the endotracheal suctioning of an adult. It was found that while about fifty one percent of those surveyed reported that they rarely used normal saline for the suctioning procedure, about thirty three percent had routinely used saline for the same purpose. While fifty five percent of the nurses used saline to remove and retrieve secretions that would perhaps block the airway, about forty five percent used the same procedure to stimulate a cough in the patient. There was a lack of understanding of the usage of saline for suctioning among the nurses: while sixty four percent reported rarely using saline before suctioning, respiratory therapists reported using normal saline for suctioning. Respiratory therapists seemed to exhibit more awareness than nurses about the benefits or disadvantages of using normal saline for suctioning purposes and to induce a cough in the patient. Evidence was able to prove that when nurses used saline for suctioning, there were more adverse effects in the patient than when a respiratory therapist used it, among them being that of greater oxygen desaturation, and other, a greater risk of cardio pulmonary infections. (Schwenker; Gift, 1998)"

Sample of Sources Used:

• Druding, Mary. C. (1997, Aug) "Re-examining the practice of normal saline installation prior to suctioning" Medical Surgery Nursing, Retrieved 8 October, 2007 from http://findarticles.com/p/articles/mi_m0FSS/is_n4_v6/ai_n18607505
• Medscape. (2007) "Should Normal Saline be Used When Suctioning the Endotracheal Tube of the Neonate?" Retrieved 8 October, 2007 from http://www.medscape.com/viewarticle/552862
• Schwenker, Ferrin, M; Gift, A. G. (1998) "A survey of endotracheal suctioning with installation of normal saline" American Journal of Critical Care, vol. 7, no. 4, pp: 255-260.
• Torpy, Janet M. (2007, Apr) "Ventilator assisted pneumonia" The Journal of the American Medical Association, vol. 297, no. 14, pp: 31-33.
• Williams, Lippincott (2006a) "Best Practices, evidence based nursing procedures" Lippincott Williams & Wilkins.

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