Endotracheal Suctioning: Coronary Artery Patient Case Analysis

This case study evaluates the effects of normal saline application before endotracheal tube suctioning in a 75-year-old patient with a history of chronic obstructive pulmonary disease (COPD). It uses strategies from the American Association for Respiratory Care (AARC) and highlights potential adverse effects such as increased pain, anxiety, elevated arterial and intracranial pressure, worsened dyspnea, inadequate oxygen exchange, and impacts on heart rate and blood pressure. The analysis incorporates the PICO (Population, Intervention, Comparison, Outcome) framework to assess the clinical practice, concluding that the use of saline before suctioning may have harmful effects, warranting further evidence-based research to justify its benefits.

Endotracheal Suctioning: A case of a Coronary Artery Patient
Name of Student
Name of Institution
Author Note

Endotracheal Suctioning: A case of a Coronary Artery Patient
Introduction
Generally, suctioning is one of the main processes used in the Intensive Care Unit (ICU) to get rid of secretions in the respiratory track. This
procedure helps to maintain the patency of the tract and hence prevent the retention of the secretions (Ayhan et al., 2015). This presentation seeks to evaluate
whether the application of normal saline prior to the endotracheal tube suctioning leads to more adverse effects in a 75-year-old patient who had a history of
chronic obstructive pulmonary disease.

The case of a 75-year-old man who had a history of chronic obstructive pulmonary disease.

Strategies Used to Search for Evidence
I would use the national strategies stipulated by the American Association for Respiratory Care (AARC) when performing endotracheal tube suctioning for the 75-
year-old patient. They include:
• Pre-oxygenation
• Only suctioning when secretions are present
• Not disconnecting the patient from the mechanical ventilator during suctioning
• Use shallow suctioning rather than deep suctioning
• Applying closed suctioning in adults
• Avoiding use of normal saline instillation
• Limiting the suctioning duration to less than 15 seconds

Summary of the Effects
Escalated pain, dread and anxiety.
Escalates the arterial and intracranial pressure.
Increased effects of dyspnea.
Insufficient oxygen exchange.
Worsens sputum recovery.
Affects processes such as the heart rate, blood pressure, trapping of saline and other risks for infections.

Summary of Evidence

Escalated Pain, Dread and Anxiety

Increases the Arterial and Intracranial Pressure

Increased Effects of Dyspnea

Inadequate Oxygen Exchange
Affects Processes such as the Heart rate, Blood Pressure and pH

Discussion on Evidence

The PICO Question