Czarnecki M L, Kaucic C L
Children's Hospital of Wisconsin, Milwaukee, USA.
Pediatr Nurs. 1999 Mar-Apr;25(2):193-6, 218.
To identify and validate the indicators registered nurses (RNs) use when deciding whether or not infants experiencing respiratory illnesses require nasal pharyngeal (NP) suctioning.
The first part of this study involved 43 RNs completing a questionnaire that examined the assessment parameters RNs use in determining when to perform NP suctioning. The second part of this study involved assessing infants' respiratory status before and after NP suctioning to determine what, if anything, changed post suctioning.
The three assessment parameters most frequently used by nurses in determining the need for suctioning were pulse oximeter readings, visible secretions, and audible secretions. The only three parameters to show statistically significant improvement post suctioning were pulse oximeter readings, visible secretions, and audible secretions.
Nurses are using valid assessment parameters when determining the need for infant NP suctioning, and NP suctioning does improve certain aspects of infants' respiratory status. There are presumed benefits to NP suctioning. However, there are also potential risks. Nasal-pharyngeal suctioning can produce bradycardia, laryngospasm, cardiac dysrhythmias, and edema and trauma to mucous membranes (Oberc, 1991), tachycardia, emotional distress, bronchospasm, and cardiac arrest (Young, 1988). The procedure involves inserting a catheter into an infant's nose and advancing it to the back of the throat (pharynx) approximately 4-8 cm (Oberc, 1991). Once at the pharynx, suction is intermittently applied and the catheter is slowly removed. The purpose of NP suctioning is to clear the airway of an infant who is unable to do so independently. However, the effectiveness and outcomes of this procedure have not been supported by research.
识别并验证注册护士（RN）在决定患有呼吸道疾病的婴儿是否需要进行鼻咽（NP）抽吸时所使用的指标。
本研究的第一部分涉及43名注册护士填写一份问卷，该问卷调查了注册护士在确定何时进行NP抽吸时所使用的评估参数。本研究的第二部分涉及在NP抽吸前后评估婴儿的呼吸状态，以确定抽吸后是否有任何变化。
护士在确定是否需要抽吸时最常使用的三个评估参数是脉搏血氧饱和度读数、可见分泌物和可闻分泌物。抽吸后显示有统计学显著改善的仅有的三个参数是脉搏血氧饱和度读数、可见分泌物和可闻分泌物。
护士在确定婴儿是否需要进行NP抽吸时使用了有效的评估参数，并且NP抽吸确实改善了婴儿呼吸状态的某些方面。NP抽吸可能存在益处。然而，也存在潜在风险。鼻咽抽吸可导致心动过缓、喉痉挛、心律失常以及黏膜水肿和创伤（奥伯茨，1991年）、心动过速、情绪困扰、支气管痉挛和心脏骤停（扬，1988年）。该操作包括将一根导管插入婴儿鼻腔并推进至咽喉后部（咽部）约4 - 8厘米处（奥伯茨，1991年）。到达咽部后，间歇性地施加吸力并缓慢抽出导管。NP抽吸的目的是清理无法自行清理气道的婴儿的气道。然而，该操作的有效性和结果尚未得到研究支持。
