To read this article and take the CE test online, visit www.ajcconline.org and click “CE Articles in This Issue.” No CE test fee for AACN members. Background Self-report is the best indicator of pain; however, pain is more difficult to assess in noncommunicative patients who may be receiving mechanical ventilation or sedated and unable to report pain. Objectives To evaluate the validity and sen...

Many common care practices during labor, birth, and the immediate postpartum period impact the fetal to neonatal transition, including medication used during labor, suctioning protocols, strategies to prevent heat loss, umbilical cord clamping, and use of 100% oxygen for resuscitation. Many of the care practices used to assess and manage a newborn immediately after birth have not proven efficac...

Purpose: Aspiration of intra abdominal fluid and debris is usually needed during different stages of the operation. This is necessary in order to protect the intra abdominal space from contamination and/or to remove blood or tissue fluids that may occur during the operation. It is also essential for obtaining a clean surgical area. Aspiration of intra abdominal fluid collecting in Douglas Pouch...

Results The VAP rates over the entire study period varied between 0 and 30.9/1000 ventilator days. The VAP rate for the year 2009 was 9.72 (22 VAP infections in 2263 ventilator days) which reduced to 3.43 (11 VAP infections in 3202 ventilator days) in the following year 2010 as a result of the interventions. The study showed hand hygiene compliance of the healthcare workers and length of stay o...

In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not s...

We previously have shown that the mucosa of the airways is injured after suctioning, but the effect of this damage on mucus transport has not been systematically investigated. We measured bronchial mucus velocity of conscious sheep after tracheostomy and bronchial mucus velocity after suctioning the bronchi with three different catheters (Bard side end-hole, Aero-Flo, and TnFlo catheters). Trac...

Both a reduction in tidal volume and in alveolar recruitment may be necessary to prevent ventilatorinduced lung injury in the management of patients with acute respiratory distress syndrome. The lung collapse associated with endotracheal suctioning produces hypoxaemia, but it also causes derecruitment, potentially aggravating lung injury. A study conducted by Dyhr and colleagues demonstrates th...

OBJECTIVE To quantify and compare variations in oxygen saturation throughout the suctioning procedure (before, during, and after) using two endotracheal suction systems: open suction system (OSS) vs. closed suction system (CSS). METHODS A prospective randomized controlled study was carried out with 39 newborn infants of gestational age ≥ 34 weeks using pressure-limited, time-cycled, continuou...

Supplemental landiolol administration (20 or 40 μg kg(-1) min(-1)) effectively diminished harmful hemodynamic changes during bronchoscopic endotracheal suctioning compared to normal saline. However, inappropriate use of landiolol (i.e., failure of evaluating factors that influence hemodynamic changes) may iatrogenically further complicate pathophysiology, and relatively higher doses of landiolo...