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Avoid Incidents & Sentinel Events

New Protocol: The 9 Nevers of Nasal Suctioning

  1. Suction Catheter Induced Nasal Trauma (SCINT)
  2. Anticoagulation
  3. Coagulopathy Issues
  4. Colonization in Nares (MRSA)
  5. Recent Nasal/Sinus Trauma, Fracture or Surgery
  6. Facial or Head Trauma/ Basal Skull Fracture
  7. Transsphenoidal Neurosurgery
  8. End-of-Life Care
  9. Occluded Nasal Passages/Deviated Septum

Protocol - Educate clinicians to screen patients before attempting nasotracheal (NT) or nasopharyngeal (NP) suctioning. Use “The 9 Nevers of Nasal Suctioning” as your screening tool.


Action Plan

  1. If answered yes to any of the above “9 Nevers”, flag patient, by placing a sign above bed: DO NOT NASAL SUCTION.
  2. Once patient is flagged, use The No-Bite V and avoid nasal suctioning & nasal trauma altogether.

SCINT - Suction Catheter Induced Nasal Trauma

SCINT is usually due to frequent NT or NP Suctioning, but can also be caused by just 1 suctioning experience. Nasal Suctioning can cause irritation, inflammation, mucous membrane breakdown and pain. This can ultimately result in severe nasal trauma & bleeding.

Contributing Factors of SCINT

1. Frequent Suctioning Needs

Patients with frequent suctioning needs receive more nasal friction and ultimately more mucous membrane breakdown.

Some conditions that can require frequent suctioning are:

  1. Pneumonias and other Respiratory Infections
  2. Dysphagia & Chronic Aspiration Patients
  3. ALS - Amyotrophic Lateral Sclerosis
  4. CF - Cystic Fibrosis
  5. CVA- Strokes with Dysphagia
  6. MND –Motor Neuron Diseases
  7. MS – Multiple Sclerosis
  8. MD – Muscular Dystrophy
  9. TBI – Traumatic Brain Injury
  10. ID - Intellectual Disability

2. Fragile Patients

To no fault of any clinician, another main cause of SCINT is the “fragility of the patient”. Many clinicians have witnessed fragile patients get nasally suctioned and seen first hand the trauma, bleeding and pain that follows.

With no warning signs, some patients anatomically have blood vessels close to the surface in their nares and thin mucous membranes. Compound that with a patient on blood thinners or a low clotting ability and you may find your patient with a severe case of SCINT.

Although we have classified 9 different types of patients that can be considered fragile in The 9 Nevers of Nasal Suctioning, we found it necessary to mention these other potentially fragile patients:

  1. Cancer Patients- who have received Chemotherapy or Radiation
  2. Long-Term Steroid Patients
  3. Frail Elderly
  4. Chronically Ill
  5. Terminally Ill

3. Coiling Suction Catheters

A contributing factor to SCINT is coiling of suctioning catheters upon insertion, leading to multiple additional attempts via the nares. To no fault of the clinician, anatomical anomalies of the nares exist and can increase the occurrence of coiling suction catheters.

4. Uncooperative Patients

On semi-awake patients, a cough reflex can be triggered and the patient can cough-out the suction catheter.

Other patients, unaware of their surroundings, can purposely tongue-out the suction catheter. Whether confused or sedated many resist suctioning simply because they do not understand what is happening. Uncooperative patients may become very difficult to suction and at times require sedation or even a second clinician for restraining.

SCINT - Key Point

If you see SCINT, STOP NASAL SUCTIONING & use The No-Bite V™!

Implementing The No-Bite V™ in your Facility

Email us at info@NJRmedical.com and coordinate an in-service. A rep will provide education on “The 9 Nevers of Nasal Suctioning” Protocol as well as technique of the device. Hands on return demonstrations will be allotted for your RT & RN staff on an anatomically correct mannequin head.


View the published articles section to fully understand the benefits of The No-Bite V™.

How The No-Bite V™ Helps

Testimonials

The No-Bite V Prevents Nasotracheal Suctioning

"I wanted to share these photos of my dad back in Nov 2016 before I even knew about the No-Bite. He was nasal suctioned in the hospital and they caused severe nasal trauma... Ouch! And no, he was not even on blood thinners, just baby aspirin."

"My dad stayed out of the hospital a record 10 Months Pneumonia-Free and Nasal Trauma-Free thanks to the No-Bite Suction!"

"Previously my dad was readmitted to the hospital at least once a month with aspiration pneumonias, but now he is doing much better."

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