View Full Version : Why sterile water for suctioning?
02-25-2007, 12:09 PM
Ian and I have been wondering why you use sterile water for suctioning. It seems to us that the first time you dip a tip or suction catheter into the water it no longer is sterile . . . does everyone use sterile water?
02-25-2007, 12:44 PM
We don't use sterile water. Even at the hospital they didn't use sterile water they used saline. At home we used distilled water or saline, but not sterile water.
02-25-2007, 01:13 PM
I've actually switched to using a mixture of water, listerine and vinegar. Kills the germs and smells good.
02-25-2007, 01:21 PM
We also use the sterile suctioning still and use individual saline bullets... I don't understand the dipping... but the saline bullets are all we have ever known - hospital & home.
02-25-2007, 02:31 PM
We use saline. That was not the hospital's idea (they said to use catheters only once) but our pediatrician suggested it. I don't know if it really keeps it clean but it doesn't seem to hurt (we'd initially used just water). We make our own and keep it in a bottle. We keep the saline in a glass next to the crib and wash it every time it's empty before refilling it.
02-25-2007, 03:12 PM
We've always used distilled water to rinse through the catheters after suctioning. According to our RT, there are minerals in regular tap water that can harbor bacteria on the catheter. That's just what we heard...... http://www.tracheostomy.com/iB_html/non-cgi/emoticons/confused.gif
02-25-2007, 05:00 PM
We use a mixture of water and vinegar. It works well for us.
02-25-2007, 06:49 PM
We went through a small period of time where we reused catheters (and it involved cleaning in sterile water). But, after we got medicaid backup, I ditched that like a bad habit. We might suction (and put the cath back in the sterile package for a few minutes and re-suction/anything longer than a few min and it was tossed/replaced with new one). If we needed a little moisture to break up the mucus, we used saline bullets. They are moving away from that practice though (using saline bullets while suctioning).... After we were done with a catheter, we rinsed the suction machine tubing with 1/2 strength vinegar/water to clean out the tubing and keep them from getting as dirty as they otherwise would (but that was NOT to clean out the suction catheters for reuse)...
02-25-2007, 07:42 PM
It is interesting to hear how everyone does everything. We don't re-use suction catheters either, but we do suck up the water to clean the tubing.
Now, we do the same with the tip and that tip obviously goes into the water over and over again and then into the trach over and over again.
I guess I won't feel guilty moving forward if we don't use "sterile" water but use distilled for this. Parker is really spitty so we tip suction about every 5 minutes while he is awake. We might use a suction catheter once every 2 days. But with all the tip suctioning, and sterile water for the bottles we are boiling a lot of water. It is hard to keep up with for something that doesn't seem like it is really necessary.
02-25-2007, 07:53 PM
Quote[/b] ] If we needed a little moisture to break up the mucus, we used saline bullets. They are moving away from that practice though (using saline bullets while suctioning)....
What are you supposed to do to break up a mucous plug if you can't use a saline bullet?
02-25-2007, 08:38 PM
Quote[/b] ]What are you supposed to do to break up a mucous plug if you can't use a saline bullet?
Good question. I would be interested to know this myself.
madelyn and rynns mom
02-25-2007, 08:53 PM
We use distilled water to rinse the suction!!!
And not all of the doctors are against the saline, frankly I think they are crazy to think you can go without it!! It causes more damage to let the lungs dry out than to put a little too much saline in them!!! If your body can handle absorbing an IV bag of saline, then it can certainly absorb 1-3cc of sterile saline in the lungs!!! And thick, sticky mucous in the lungs is more of a bacteria breeding ground, than sterile saline drops anyday!!!!
02-25-2007, 09:18 PM
We were instructed in the hospital to use saline bullets judiciously, only if the mucous was thick and needed some help to bring it up. I know Ian and I have never used it at home and only one of the nurses has done it.
I don't know what else you would do either. I wouldn't hesitate at all to do it if I thought he needed it.
02-25-2007, 09:20 PM
We use sleeved sx caths so they're reusable...and we use either sterile water or saline. I would rather be safe than sorry.
If you're not reusing the caths it doesn't really matter what you use.
The saline controversy has been going on for years. My opinion is, if there's a mucous plug, then the obvious choice is saline. But I don't love the use of saline w/every sx. It's not neccessary to introduce any extra fluids into the lungs due to the chance of aspiration.
I've noticed some nurses/hospitals do either one or the other. I ask everyone to only use saline with thick secretions or plugs.
Not just for squirting in for the heck of it.
Trish- When you use the Listerine, I'm guessing you don't reuse your catheters? I got this awful visual of someone sx'g w/Listerine going into the trach stoma. Oh my!
02-25-2007, 10:27 PM
we use sodium chloride water.
I just wet the suction catheter so it slides in easier and any dry guk around the door of the trach usually clings to it.
Then I suck up the remaining water to clean the tubing but toss the catheter and use new when he needs more suctioning. I do use saline bullets when he's dry or has a plug.
02-26-2007, 01:17 AM
It's a very small amount but yes we reuse. We always have reused. BUT we also do not suction past the tip of the trach, so there is no touching anything.
madelyn and rynns mom
02-26-2007, 10:04 AM
More info for my post~ we use our saline liberally if she is thick secretioned or plugged, but we do not use it with regular sxing!! She does not need it then!
02-26-2007, 10:08 AM
Quote[/b] ]we use our saline liberally if she is thick secretioned or plugged, but we do not use it with regular sxing
02-26-2007, 04:17 PM
We use saline bullets if Sam has a plug, which is very rarely. We only use caths once then throw away - we don't have the sleeved caths.
03-01-2007, 05:41 PM
I dont use the water to clean the cath, but our nurses sometimes do if Emma is thick. The point is to clean the cath so you can continue to use it during that suction, like if there is a thick icky plug on the end or something.
If you use a sterile box that comes in the cath kits with sterile water you are keeping the process sterile. You are taking the icky cath and cleaning it with sterile water and putting it back into the trach, which does have trach germs on it but no other outside germs.
But we only use sterile saline for putting down the trach
03-02-2007, 06:22 AM
Quote[/b] (suzanne2545 @ Feb. 25 2007,23:42)]Now, we do the same with the tip and that tip obviously goes into the water over and over again and then into the trach over and over again.
Ok, ya lost me...what "tip" are you referring to? Am I missing something? Deb
03-02-2007, 10:32 AM
We use a catheter for about 3 to 4 hours but of course if she is sick, we change more frequently. We use saline to clean the catheters. I bought these fab Rubbermaid soup bowls, for lunches. They are plastic and they have a flip opening in the center of the bowl big enough for a spoon to go in and out. We used them exclusivly for Indie's saline cleanser. I love them.
03-02-2007, 01:13 PM
Does anyone have a part number/manufacturer for the sleeved catheters? Tommy gets suctioned 20+ times per day, so medicaid will not pay for not reusing catheters. The doctors would prefer that we not reuse, but what can we do. They have settled on 250 caths per month, but that will still not cut it.
03-02-2007, 04:40 PM
Just to clarify, seems like some of you are talking about two different things. One is instilling saline into the tracheostomy tube to help suction thick mucus. The other question is what to use to rinse the catheter after suctioning.
You should always use sterile saline when instilling into the tracheostomy tube, because it's sterile and also because saline more closely matchs the body's natural fluids. The saline bullets work best for this, but you can also use a small syringe if your insurance will not cover the bullets.
For rinsing the suction catheter after or between suctioning, I also use saline. While sterile water is OK too, I would not recommend using distilled water, vinegar or listerine. Just keep it simple and stick with sterile saline.
(But vinegar is sometimes used to clean catheters after use, if you must reuse them. Cleaning with 1/2 strength vinegar is OK, as long as you rince in sterile saline after cleaning them.)
TommysDad, I don't have the part number for the "sleeved catheters", but you can just slide the catheter back into the sleeve it came in and reuse it a few times. But keep the end of the catheter and the sleeve as clean as possible and don't leave it lying around for a long time, change it out several times a day (depending on how many catheters your insurance gives you).
Of course it is ideal to not reuse catheters, but this is not always possible in the real world.
03-02-2007, 10:11 PM
We use a closed-system, bi-directional ballard as well. We use them for a week. They are from Kimberly-Clark.
Here's the link:
Kimberly-Clark Ballard (http://nacrm.kcmkt.com/scripts/wgate/zkcnab2c/!?p_shop=ZKCHCSHOP)
03-03-2007, 08:48 AM
Melisande, this is interesting. But I don't think this is what people are referring to when they say "Sleeved" Catheter, you wouldn't want to use a sleeved cath for a week.
Sleeved suction catheter:
I'd be interested in hearing more about this bi-directional closed system. Can it be use with and without a vent? Do you know how expensive these are compared to a typical catheter? Can you post a photo of it? There are some on the web, but too small to really get a good look at it. Thanks!
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