Endotracheal suctioning (ET) for patients receiving mechanical ventilation is routinely done in the acute care setting. Practice over time has varied from suctioning done at routine intervals with the instillation of normal saline along with checking breath sounds before and after suctioning to assess for improvement, to suctioning only when a clinician-based assessment indicates need.
However, only recently have guidelines1 been published that can assist both nurses and respiratory therapists in using evidence-based clinical cues for patient assessments. In their recent study, Sole and colleagues2 demonstrated that these recommendations could be appropriately applied in the clinical practice environment to improve assessment of need for and adequacy of suctioning. They found that auscultation of coarse crackles over the trachea was the most common indicator for ET suctioning and, further, that assessment of lung sounds to identify the need for suctioning is not recommended.
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