Question

A 58 year-old male patient is receiving mechanical ventilation in the ICU on the following settings: VC,SIMV, VT 650 mL, f 12/min, FIO₂ 0.65, PEEP 10 cm H₂O. He has a large amount of thick, yellow secretions. How should the respiratory therapist suction this patient?

1) Limit suction time to 5 seconds or less.
2) Use a closed-system suction catheter.
3) Suction Q1H and PRN.
4) Use a 10 Fr suction catheter.

Answer 1

For a 58 year-old male patient on mechanical ventilation, using a closed-system suction catheter is the most appropriate method to suction thick, yellow secretions, balancing the need to clear the airway with the maintenance of alveolar ventilation and prevention of potential complications.

Step-by-step explanation:

The appropriate method for a respiratory therapist to suction thick, yellow secretions from a 58 year-old male patient receiving mechanical ventilation is most likely to use a closed-system suction catheter. This technique minimizes the introduction of pathogens into the airway and prevents the loss of positive end-expiratory pressure (PEEP) during the suctioning process. While the suction duration, frequency, and catheter size are important considerations, they must be balanced against the patient's specific needs and conditions, following the hospital's protocols and the respiratory therapist's clinical judgment.

In this case, setting a specific suction time limit to 5 seconds does not account for the possibility that the patient may require longer suctioning to clear the thick secretions effectively. Suctioning on a set schedule (e.g., Q1H) may be excessive unless clinically indicated, which could also lead to airway trauma. The size of the suction catheter (e.g., 10 Fr) must be appropriate for the patient's airway and the viscosity of the secretions. Alveolar ventilation must be maintained, and excessive suctioning can interfere with this.