Nurse’s Challenge in Reducing the Suffering from Endotracheal Suctioning in Adult Patients with Intubation : ความท้าทายของพยาบาลในการลดความทุกข์ทรมานจากการดูดเสมหะ ในผู้ป่วยผู้ใหญ่ใส่ท่อช่วยหายใจ

บทคัดย่อ

          Suffering from endotracheal suctioning in adult patients with artificial airway is caused by the difference of secretion suctioning from the standard nursing practice guideline.  As a result, their traumas of trachea are created by inserted suctioning catheter and respiratory intubation movement. They have oxygen depletion and psychosocial problems. Nurses could help them to reduce their suffering by the followings. 1) chose the deep or shallow insertion of suctioning tube according to the sputum amount and the duration of each suctioning event should be 10-15 minutes 2) reduce the endotracheal tube movement by shortening when its length from restrained at mouth or nose longer than 4-5 centimeters and performing this practice with 2 staffs, one performs suctioning and another helps in fixation of artificial airway 3) Hypoxia reduction by delivering high percentage of Oxygen, increasing the lung capacity by applying the suction catheter size not larger than 1 in 2 of the respiratory tube’s inner diameter, using 2-3 catheters in each suctioning, taking a 5 minute-pause between each catheter insertion, turning the catheter clockwise and anticlockwise and pausing for a while when passing through the thick secretion, increasing the humidity via the humidification system, applying the suction pressure between 80 to150 mm. Hg and maintaining the PEEP level by connecting it with AMBU bag and 4) minimize the patients’ anxiety and fear by giving them the proper information, telling them before suctioning, building the relationship, applying the relaxing technique and medication. Therefore, the adherence of standard nursing practice guideline for endotracheal suctioning could be a care guideline to reduce the suffering in adult patients with intubation.

          Keywords : Suffering reduction, Endotracheal suctioning, Adult patient with intubation, Nursing