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Direct Instillation of Medications/Lubrication Agents via Artificial Airway (2.30)

Direct Instillation of Medications/Lubrication Agents via Artificial Airway (2.30) - Policies, Clinical, UWHC Clinical, Department Specific, Respiratory Care Services, Aerosol Therapy

2.30




1

2.30 Direct Instillation of Med/Lubricating Agent via Artificial Airway
Category: UWHC Patient Care Policy
Effective Date: April 25, 2016
Version: Revision
Manual: Respiratory Care Services
Section: Aerosol Therapy

I. PURPOSE
The following medications can be directly instilled into an artificial airway.
A. Mucolytics for the treatment of thick viscous secretions
B. Surfactants for the treatment or prophylaxis of respiratory distress syndrome
C. Anesthetics to control pain and suppress cough

II. CONTRAINDICATION
Known hypersensitivity to instilled medication/agent

III. POLICY
A. All patients will be assessed by a respiratory care practitioner (RCP).
B. Therapy will be provided in accordance with a provider’s order.
C. An artificial airway must be present for an RCP to instill medications.
D. Instilled medications are charged as a nebulizer treatment.

IV. EQUIPMENT
A. Medication/agent to instill.
B. Syringe
C. Suction Catheter kit or in-line suction kit.

V. PROCEDURE
A. Review and acknowledge provider’s order.
B Review patients chart.
C. Obtain the appropriate equipment.
D. Sign out medications in the Medication Administration Record (MAR).
E. Introduce yourself to the patient and/or family. Explain the procedure
F. Assess the patient throughout the procedure.
G. Administer medication/agent.
1. Draw the desired amount of instilling agent into a syringe.
2. Inject the medication through the in-line suction catheter or other adapter if necessary.
3. Leave medication/agent in the patient’s lungs 1 to 5 minutes. Continue to ventilate the
patient via mechanical ventilation or manual resuscitator.
H. Suction if indicated.


VI. REFERENCES
A. Respiratory Care Services (RCS) policy and procedure # 3.42 “Suctioning.”
B. Micromedex
C. Administration of Aerosolized Medications – Pediatric/Adult – Inpatient/Ambulatory
Clinical Practice Guideline
D. AARC Clinical Practice Guidelines
E. Respiratory Care Services (RCS) policy and procedure # 3.56 “Surfactant”

Approved by Director and Medical Director of Respiratory Care:

A copy of this Policy & Procedure is available in the Respiratory Care Office [E5/489].