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Application of closed suction catheters in patients with severe head injury

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Author : Joe Wong
Update time : 2021-01-06 09:47:39

Application of closed suction catheters in patients with severe head injury

Severe craniocerebral injury has a rapid onset, rapid progress, many complications, and high mortality. It is often accompanied by varying degrees of respiratory disorders. It must rely on tracheotomy or mechanical ventilation to maintain breathing. Because the patient's cough and swallowing reflex disappear, respiratory secretions cannot be discharged, and long-term bed rest is prone to pulmonary infection, it is very important for patients to strengthen respiratory care. From December 2005 to June 2006,the Second People's Hospital Affiliated to Sun Yat-sen University treated 89 patients with severe head injury. The use of closed suction catheter combined with respiratory care can effectively reduce lung complications. It is summarized as follows.

For the management of closed suction catheter, indicate the date and time of use for the closed suction catheter, humidifying fluid, and washing fluid. Replace every 24 hours. Flush the suction catheter with flushing solution before suctioning to check the suction pressure, whether the suction tube is unobstructed, and moisten the suction tube at the same time, lower the suction tube and tracheal intubation or tracheotomy tube The friction between the suction tube facilitates the insertion of the suction tube; the suction tube is rinsed in time after suction to prevent the sputum from sticking to the inner wall of the lumen to block the suction tube.

To prevent pulmonary infection and airway mucosal damage, choose a closed suction catheter with a suitable model. Generally, the diameter of the suction tube/the inner diameter of the tracheal intubation is less than 1/2 to avoid excessive suction pressure and atelectasis. Adjust the appropriate negative pressure suction, the general suction pressure is 10-20kPa, in order to reduce the damage to the tracheal mucosa by suction, the suction time is less than 15s, and each continuous suction should not exceed 3 times. Avoid repeated lifting and inserting in the trachea , When exiting, keep pressing while rotating while attracting.

Observe the condition in time and evaluate the effect of sputum suction. The nurse should observe in time to evaluate the patient's breathing, sputum volume and sputum suction effect. Patients with craniocerebral injury are often unstable in breathing, and their clinical symptoms, blood gas indicators, blood oxygen partial pressure and blood oxygen saturation should be carefully observed to avoid secondary damage caused by hypoxemia.

A little summary of the closed suction catheter

1. The operation is simple, convenient, time-saving, and timely to meet the needs of patients. The traditional suction method requires preparations before suction, such as pouring the irrigation solution, opening the suction tube, connecting the suction tube, wearing sterile gloves, and mechanical ventilation The patient needs to take off the ventilator and operate by 2 people at the same time; use a closed suction tube, because there is a transparent film outside the suction tube, there is no need to wear sterile gloves, there is no need to take off the ventilator, stop mechanical ventilation, and open the suction device You can suck sputum. It takes about 1 minute and 30 seconds to use the closed suction tube from start to end, while the traditional suction method takes about 3 minutes.

2. The closed suction catheter is connected to the artificial airway and mechanical ventilation through a transparent three-way, forming a closed system. It has changed the condition of temporarily separating the ventilator from the patient's artificial airway and interrupting the mechanical ventilation during the sputum suction process for many years, resulting in the patient's hypoxia.

3. Avoid contamination and cross-infection. The closed suction tube is a kind of suction tube with the advantages of a closed system. It has few moving parts, only the suction control valve is connected to the negative pressure suction, and the other parts are in a closed state. Therefore, The operation is completely carried out under airtight conditions, which avoids the contamination of open sputum suction operations inadvertently, reduces the chance of exogenous infection, and reduces the time for lung infection to occur. Since the closed suction tube has a complete airtightness, it can avoid the patient's coughing and sputum splashing during suction, contaminating the hands, clothes and bed units of medical staff, and reducing cross-infection.

4. Save manpower and reduce workload. The closed closed suction catheter can be used repeatedly within 24 hours, and there is no need to replace the suction tube every time for suction, thereby reducing the labor intensity of the nursing staff and saving resources.