The patient should be closely monitored throughout procedure for adverse effects. End-tidal CO2
monitoring should remain attached to patient while hand ventilating to observe CO2 trend and to ensure
correct placement of tracheal tube.
Saline instillation has proven controversial and the evidence is inconclusive therefore routine use of
saline is not recommended, however in individual circumstances where the patient has thick tenacious
secretions measured volumes of saline may be useful. Minimal amount of saline to be effective should be
used and volume documented.
There are no absolute contraindications to tracheal suction however special consideration should be given
when frank pulmonary oedma or hemorrhage is present.
9. Implementation
Education of nursing staff at bedside, induction, respiratory and high dependency modules
Guideline available on CIS and intranet
CIS documentation adjusted to comply with guideline
Paper copy of guideline available in unit