Q How deeply should I go when I suction an endotracheal tube (ETT) or tracheostomy tube (TT)?

A Mary Frances Pate, RN, DSN, and Terry Zapata, RN, RRT, reply: ______

ETT and TT suctioning is frequently performed by critical care nurses. Regardless of the frequency and seemingly routine nature of this activity, suctioning is not a benign procedure. The purpose of suctioning is to remove secretions that are not accessible to bypassed cilia. Therefore, insertion of suction catheters only as far as the end of the placed ETT and TT has been recommended.1,2 

Research describing the potential negative effects of deep suctioning has been reported dating back to the 1960s.3 However, it is still a common practice for nurses to insert suction catheters until they meet resistance and then apply suction. Although this practice is not supported in the research, a survey of pediatric nurses revealed that...

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