I worked in the Middle east with european nurses. I was told by more than one RN who are forbidden to instill in their country, that they have to change out ETT's due to plugging on a fairly frequent basis. I don't know about you but in nearly 20 years i don't recall needing to retube due to a plugged tube. So I ask which is worse instill prn as needed or reintubating? I agree with RT JOHN saline does not thin, but jars the secretion loose. Next time you don't get much(and you know it's there) with suctioning try the following; increase you VT(during suctioning) and instill, bet you get something if not tons. Also, instilling and lavage with bronch are not 100% comparable, one goes through the ETT and one doesn't. There is a time to instill. Should it be done with every suction, probably not, but it should be done on regular intervals(in my opinion).

GJ

This message has been edited. Last edited by: GJ,RRT,

each patient situation should be evaluated and levage/sx or not levage/sx as indicated. as a therapist in the feild for more than 20 years I can tell you that levage/sx can be indicated and beneficial.