The therapist is performing endotracheal suctioning on a patient who has thick tracheobronchial secretions. The patient's nurse suggests that the therapist instill 5 ml of normal saline directly down the ETT to thin the patient's secretions. How should the therapist respond to this suggestion?

Question

A. Comply with the nurse's suggestion.
B. Tactfully inform the nurse that 5 ml of sterile water would produce better results.
C. Enlighten the nurse that her suggestion has little to no merit.
D. Instill 10 ml of normal saline, instead of 5 ml.

Answer 1

?ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Commonly, therapists and others often instill 5 to 10 ml of normal saline directly into a patient's ETT when the patient's secretions are thick and difficult to suction. However, no evidence exists supporting this practice. Patient's generally violently cough in response to this practice, but the tracheobronchial secretions do not become less thick and more easily evacuated through suctioning. The concern is this practice may dislodge bacteria-laden biofilm from the internal walls of the ETT, producing infectious consequences.
D. Incorrect response: See explanation C.