The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

THE EFFECT OFNP SUCTIONING ON SYMPTOM SCORES IN BRONCHIOLITIS PATIENTS

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Glenna McKinleyRRT, BS, Julie Ballard RRT, BS. John Salyer RRT, MBA, FAARC. Quality CareAssessment Team. Primary Children?s Medical Center. Salt Lake City, Utah.

Introduction: Webelieve nasopharyngeal suctioning (NP) with a catheter down to the hypopharynxplays an important role in the care of pediatric pts with bronchiolitis. Weuse a previously described symptom score (range 0-9) we call the bronchiolitisscore (BS) which improves in most of these pts after suctioning, reducing theneed for bronchodilators 1. This study was designed to describe theeffect of NP on BS in these pts.

Methods: Datawere collected from the medical record from November 2000 - April 2001. Inclusioncriteria were all pts with a diagnosis of bronchiolitis, age < 24months, and non-ICU. We included pts who had documentation of the BS beforeand after at least one NP intervention within the first 24 hrs of admission.Data were compiled and standard descriptive statistics computed. Pts and NPinterventions were sorted according to whether there was improvement, worsening,or no change in the BS after NP. A decrease in the BS > 1 was an improvement,while an increase > 1 was a worsening.

Results: Weidentified 581 pts who met the diagnostic and age criteria, of whom 474 hadadequate documentation. There were 1789 NP interventions in these pts.

Resultsof suctioning data in tables are numbers (%)
Resultsamong pts who showed improvement only
 SuctioningInterventionsPatientsMagnitudeof ImprovementSuctioningInterventions
Improvement1080(60)385(81)By4-7 points

29 (3)

NoChange664(37)85(18) By2-3 points315(29)
Worsened45(3)4(1)By1 point736(68)
Total1789(100)474(100)Total1080(100)

Discussion: 81% of patients had at least one episode of NP suctioning resultingin an improvement in symptoms, and of these about 1/3 were large improvements.We have received no formal or informal reports of adverse events associatedwith NP in any of these pts. Our experience is that properly trained staff cansafely perform NP. We suggest that NP is an important part of the care of bronchiolitispts. We speculate that improvements in NP are associated with improved oralfeeding, and thus reduced need for IV fluids, and reduced need for supplementaloxygen. We plan to study this further.

1. Respir Care (abstract). 2000;45:1009.

OF-01-241

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