Abstract

Abstract: The purpose of this study was to determine whether disposable suction catheters can be reused and to establish the need for a standardized approach for the care of tracheostomy in each hospital. The study was conducted in the intensive care unit of a tertiary surgical hospital. There were two methodologies used in this study. We retrieved folders and conducted semi-structured interviews with the primary caregivers – nurses and doctors. The inclusion criteria admitted only brain and spine injured patients who had tracheostomy within the first two weeks of ICU admission. The themes arising from the evaluation were:

1. Suction catheters were reused for 12-24hours in each patient. These catheters were stored in containers in a solution of normal saline and occasionally savlon antiseptic (5 mg of cetrimide (0.5% w/w) and 1 mg of chlorhexidine digluconate (0.1% w/w)).
2. The frequency, technique and assessment of the need of airway suctioning were all inconsistent.
3. Pneumonia developed in all cases of the first cycle. 62.5% (10 patients) had a second episode and 12.5% (2 patients) had >2 episodes of pneumonia, one mortality was recorded directly attributable to the complications of pneumonia.
4. In the re-audit, 8 patients met the inclusion criteria. 3 patients (37.5%) suffered one (1) episode of pneumonia and only 1 (12.5%) had a second episode. No mortality was recorded.

In conclusion, a standard practice guideline is necessary for tracheostomy care in each hospital. In low-resource setting, suction catheter reuse and poor hygienic practices contribute to increasing rate of pneumonia.

Keywords: suction catheter reuse, pneumonia, tracheostomy, brain and spine injury