Impact of saline instillation on Endotracheal Tube before Suctioning

LEADERSHIP BEHAVIOURS
by (Name)
The Name of the Class (Course)
Professor (Tutor)
The Name of the School (University)
The City and State where it is located
The Date
The surfacing of evidence-based practice in the health sector was one of the success stories in health in the 1990s. After a period of 27 years, the movement has had a noteworthy impact on policy in health care. For instance, there are many centers in the UK, for evidence-based child services, evidence-based medicine, and mental health services. This organizational structure has come along with a panoply of journals and newsletters, practice manuals, software packages and toolkits, e-mail and online forums. The depth of influence in medicine in the UK has been paralleled by an international breadth in the expansion. The movement has speedily become an international phenomenon going beyond national borders.
Failure of the respiratory system is among the most common causes of longer hospital stay or admission in acute care practice. The condition is often accompanied by various medical conditions that include stroke and other conditions that are neurological, cardiovascular complications, and respiratory illnesses. Patients with the condition (acute respiratory failure) need to be put under medical watch urgently by health care providers for prevention of further worsening that can ultimately cause mortality. With advancements in the medical field, death can be greatly prevented if quick interventions are provided properly.

Intubation of the TT (tracheostomy tube) and ETT (Endotracheal tube) are the regularly used artificial advanced airways in the management of failure of the respiratory system .
The healthcare system has been expended to ensure that patients get the right medical care and quality healthcare in all health institutions. Quality healthcare is nowadays achieved in hospitals, rehabilitative care, and many other places . The expansion in this sector has made it easier for patients to receive quality treatment that they desire. Instillation of saline before suction with an artificial airway is a conventional intervention in nursing. Because there is lack of empirical evidence supporting this practice, caregivers in the hospital setting can decide arbitrarily when it is appropriate. 3-10 ml of a normal solution of saline is routinely instilled by practicing nurses into the airway before suction so as to loosen secretion, increase clearance for secretions and for lubricating the “suction catheter.”
Even though the expansion and rise of evidence-based practice have been magnificent, the practice has come along with substantial amounts of criticism from challengers in other fields as well as those in medicine. Advocates and supporters point out that the approach results in best uses of resources and best. On the other hand, opponents of the practice claim that the practice is a clandestine way of resource rationing. Studies in this field for patients receiving “mechanical ventilation” or those intubated have been inconclusive. Research carried out by Ayhan et al., 2015 concluded that “Although the effects of normal saline instillation on hemodynamic and pneumonia incidence remain controversial, this procedure significantly decreases the oxygenation. Therefore, the use of this procedure is not recommended”. Nonetheless, normal instillation of saline is often used by practicing nurses to manage tenacious and thick secretions in clinical settings. Studies need to be undertaken for the purpose of determining how effective alternative applications to instillation of saline in secretion management. Another research carried out by “The University of Arkansas for Medical Sciences” concluded that “Instillation of normal saline before endotracheal suctioning has an adverse effect on oxygenation as indicated by mixed venous oxygen saturation. This finding contradicts the assumption that instillation of normal saline improves oxygenation status.”
Bibliography
Ayhan, H, S Tastan, E Iyigun, Y Akamca, E Arikan, & Z Sevim, “Normal saline instillation before endotracheal suctioning: “What does the evidence say? What do the nurses think?”: Multimethod study.”. in Journal of Critical Care, 30, 2015, 762-767.
Buccheri, R, & C Sharifi, “Critical Appraisal Tools and Reporting Guidelines for Evidence-Based Practice.”. in Worldviews on Evidence-Based Nursing, 14, 2017, 463-472.
Caruso, P, S Denari, S Ruiz, S Demarzo, & D Deheinzelin, “Saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia*.”. in Critical Care Medicine, 37, 2009, 32-38.
D, K, “Instillation of normal saline during endotracheal suctioning: effects on mixed venous oxygen saturation. – PubMed – NCBI.”. in Ncbi.nlm.nih.gov, , 2018, <https://www.ncbi.nlm.nih.gov/pubmed/10392222> [accessed 12 February 2018].
Jagannathan, N, & T Pak, “An unusual complication of endotracheal tube suctioning.”. in Journal of Anesthesia, 23, 2013, 170-171.