Literature

Sherpa Suction Guide

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 Overview of Publications Supporting Above-the-cuff Suctioning

Current scientific evidence supports the use of above the cuff suctioning to prevent ventilator-associated pneumonia (VAP) and ventilator-associated events (VAEs) in adult patients. The following abstracts have been extracted from various journals and resources.
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 Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update

A recent update from the Society for Healthcare Epidemiology on recommended practices for VAP prevention including removal of pooled secretions above the cuff as a recommended basic practice for long term ventilated patients.
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NEMO Gauge

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Prompt correction of endotracheal tube positioning after intubation prevents further inappropriate positions

A 2011 study (n=44 surgery patients) published in the Journal of Clinical Anesthesia showed that 13.6% of endotracheal tubes placed were in critical position, ≤1cm above the carina, and that only half were correctly identified by chest auscultation.
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Chest Radiography after endotracheal tube placement: is it necessary or not?

A recent study (n=381 ED patients) published in the American Journal of Emergency Medicine found that 11.8% of intubations were less than 2cm from the carina after physical examination including symmetrical chest expansion and bilateral auscultation of breath sounds in 5 foci.
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