I recently read the article, “Airway Management” (April 2004:93–96), and noticed that information related to depth of endotracheal tube (ETT) and tracheostomy tube (TT) suctioning was not addressed. It is still common practice for nurses to insert suction catheters until they meet resistance and then apply suction. The resistance felt is when the catheter meets the carina or bronchial mucosa. Inserting a suction catheter to this point can cause negative consequences for the patient.

Alternately, some nurses insert suction catheters until resistance is met, and then pull the catheter back before applying suction. Unfortunately, meeting resistance and then “pulling back” before suctioning is not a solution.1 Research suggests that catheter contact rather than suction is responsible for mucosal damage.2 Studies in kittens have shown that inserting a catheter to resistance caused as much damage as insertion to...

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