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THE EFFECT OF
NP SUCTIONING ON SYMPTOM SCORES IN BRONCHIOLITIS PATIENTS.
Glenna McKinley
RRT, BS, Julie Ballard RRT, BS. John Salyer RRT, MBA, FAARC. Quality Care
Assessment Team. Primary Children?s Medical Center. Salt Lake City, Utah.
Introduction: We
believe nasopharyngeal suctioning (NP) with a catheter down to the hypopharynx
plays an important role in the care of pediatric pts with bronchiolitis. We
use a previously described symptom score (range 0-9) we call the bronchiolitis
score (BS) which improves in most of these pts after suctioning, reducing the
need for bronchodilators 1. This study was designed to describe the
effect of NP on BS in these pts.
Methods: Data
were collected from the medical record from November 2000 - April 2001. Inclusion
criteria were all pts with a diagnosis of bronchiolitis, age < 24
months, and non-ICU. We included pts who had documentation of the BS before
and after at least one NP intervention within the first 24 hrs of admission.
Data were compiled and standard descriptive statistics computed. Pts and NP
interventions 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: We
identified 581 pts who met the diagnostic and age criteria, of whom 474 had
adequate documentation. There were 1789 NP interventions in these pts.
Results
of suctioning data in tables are numbers (%) |
Results
among pts who showed improvement only |
| |
Suctioning
Interventions |
Patients |
Magnitude
of Improvement |
Suctioning
Interventions |
| Improvement |
1080
(60) |
385
(81) |
By
4-7 points |
29 (3) |
| No
Change |
664
(37) |
85
(18) |
By
2-3 points |
315
(29) |
| Worsened |
45
(3) |
4
(1) |
By
1 point |
736
(68) |
| Total |
1789
(100) |
474
(100) |
Total |
1080
(100) |
Discussion: 81% of patients had at least one episode of NP suctioning resulting
in an improvement in symptoms, and of these about 1/3 were large improvements.
We have received no formal or informal reports of adverse events associated
with NP in any of these pts. Our experience is that properly trained staff can
safely perform NP. We suggest that NP is an important part of the care of bronchiolitis
pts. We speculate that improvements in NP are associated with improved oral
feeding, and thus reduced need for IV fluids, and reduced need for supplemental
oxygen. We plan to study this further.
1. Respir Care (abstract). 2000;45:1009.
OF-01-241
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