10. Use standard precautions while suctioning respiratory tract secretions. Pro - Recommends appropriate infection prevention and control practices SHEA are used at all times, including aseptic techniques when suctioning secretions and handling respiratory therapy equipment. ZAP Makes No Recommendations ATS Makes No Recommendations CDC Makes No Recommendations 11. Use orotracheal intubation instead of nasotracheal. Pro- Recommends orotracheal intubation over nasotracheal intubation SHEA based on the increased risk of sinusitis. Pro- Recommends the use of the orotracheal route for intubation when ZAP intubation is necessary. Recommends orotracheal intubation over nasotracheal intubation Pro- ATS based on a trend toward reduction in VAP rates and sinusitis. Pro- Recommends the use of orotracheal intubation over nasotracheal CDC intubation unless contraindicated. 12. the use of prophylactic systemic antimicrobials. Pro- Recommends prophylactic aerosolized or systemic antimicrobials SHEA should not be used for routine VAP prevention. ZAP Makes No Recommendations ATS No Recommendations CDC Makes No Recommendations 13. Avoid non-essential tracheal suctioning. All Guidelines Make No Recommendations New South Wales Statewide Recommends that tracheal tube suctioning should not be carried out Pro – Guideline for Intensive Care on a routine basis, but rather out of clinical need to maintain the patency of (Rolls, 2009) 9 the tracheobronchial tree. 14. Avoid gastric over-distention. SHEA Pro- Recommends the avoidance of over distention. ZAP Makes No Recommendations ATS Makes No Recommendations CDC No Recommendations
10. Use standard precautions while suctioning respiratory tract secretions. SHEA Pro - Recommends appropriate infection prevention and control practices are used at all times, including aseptic techniques when suctioning secretions and handling respiratory therapy equipment. ZAP Makes No Recommendations ATS Makes No Recommendations CDC Makes No Recommendations 11. Use orotracheal intubation instead of nasotracheal. SHEA Pro- Recommends orotracheal intubation over nasotracheal intubation based on the increased risk of sinusitis. ZAP Pro- Recommends the use of the orotracheal route for intubation when intubation is necessary. ATS Pro- Recommends orotracheal intubation over nasotracheal intubation based on a trend toward reduction in VAP rates and sinusitis. CDC Pro- Recommends the use of orotracheal intubation over nasotracheal intubation unless contraindicated. 12. the use of prophylactic systemic antimicrobials. SHEA Pro- Recommends prophylactic aerosolized or systemic antimicrobials should not be used for routine VAP prevention. ZAP Makes No Recommendations ATS No Recommendations CDC Makes No Recommendations 13. Avoid non-essential tracheal suctioning. All Guidelines Make No Recommendations New South Wales Statewide Guideline for Intensive Care (Rolls, 2009) 9 Pro – Recommends that tracheal tube suctioning should not be carried out on a routine basis, but rather out of clinical need to maintain the patency of the tracheobronchial tree. 14. Avoid gastric over-distention. SHEA Pro- Recommends the avoidance of over distention. ZAP Makes No Recommendations ATS Makes No Recommendations CDC No Recommendations
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