Endotracheal suction catheter
OVERVIEW
- endotracheal suction catheter
USE
- clears secretions from the airways when the cough reflex is impaired or absent
DESCRIPTION
- fine bore suction catheter that is can be passed down an endotracheal tube
- sterile sleeve allows repeated use
METHOD OF USE
- suction catheter is passed via an endotracheal or tracheostomy tube or via a nasal/oral airway to the carina
- this may stimulate a cough in a non-paralysed patient
- catheter is pulled back 1 cm
- then suction is applied on withdrawal
CONTRAINDICATIONS
- unexplained haemoptysis
- severe coagulopathies
- severe bronchospasm
- laryngeal stridor
- base-of-skull fracture
- haemodynamic instability
FURTHER INFORMATION
- Suction catheter diameter should not be greater than 50% of the diameter of the airway through which it is inserted as large negative pressure can be generated intrathoracically without air entrainment
- The use of suction following effective manual hyperinflation optimises removal of secretions
- Instillation of normal saline prior to suctioning is controversial; it may stimulate a cough, maximising secretion mobilisation and clearance.
Advantages
- Stimulation of a cough when reflex is impaired by mechanical stimulation of the larynx, trachea or large bronchi
- Removal of secretions from central airways when cough is ineffective or absent
Disadvantages
- invasive procedure
- tracheal ulceration or perforation
- Hypoxaemia can be induced secondary to suctioning (limited by pre- and postoxygenation)
- Cardiac arrhythmias due to hypoxia
- Tracheal stimulation may produce increased SNS activity or a vasovagal reflex producing cardiac arrhythmias and hypotension
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
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