Related Experiment Video
Updated: Apr 27, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
Assessment of pain during endotracheal suction in the pediatric intensive care unit
Duygu Sönmez Düzkaya1, Sema Kuğuoğlu2
1Istanbul University, Istanbul Faculty of Medicine, Directorate of Nursing Services.
Insights
Pediatric intensive care unit patients experience pain during endotracheal suctioning (ETS). Implementing evidence-based suctioning guidelines is recommended to reduce patient distress and improve pain management.
Area of Science:
- Pediatric Critical Care Medicine
- Nursing Research
- Pain Management
Background:
- Endotracheal suctioning (ETS) is a common procedure in pediatric intensive care units (PICUs).
- Pain and distress associated with ETS can negatively impact patient outcomes.
- Standardized protocols for ETS are crucial for effective pain management.
Purpose of the Study:
- To evaluate pain experienced by pediatric patients during endotracheal suctioning.
- To compare pain levels between routine ETS and ETS following nursing guideline education.
- To assess the impact of analgesia and sedation on pain scores during ETS.
Main Methods:
- A two-level study involving 65 pediatric patients and 18 nurses in PICUs.
- Level 1: Routine ETS. Level 2: ETS with nurses educated on guidelines.
- Pain was assessed using Wong-Baker FACES Pain Rating Scale and the FLACC scale. Data analyzed using SPSS.
Main Results:
- No statistically significant difference in pain scores between routine ETS and guideline-based ETS.
- Patients receiving analgesia and sedation showed lower pain scores, though not statistically significant.
- Findings indicate significant patient distress due to pain during ETS.
Conclusions:
- Endotracheal suctioning is a painful procedure for pediatric patients in the ICU.
- Adherence to established suctioning guidelines is recommended to mitigate pain and distress.
- Further research may be needed to optimize pain management strategies during ETS.
Abstract:
This research was planned as a two-level definitive and comparative study to evaluate pain during endotracheal suction (ETS) in pediatric intensive care units (PICUs). This study was comprised of patients admitted to and the nurses working in the PICU. Cases were selected among PICU patients (N = 65) who met the study criteria and nurses (N = 18) who cared for them from January 1 to July 2, 2008. Routine ETS was applied as the first level of the study. For the second level, an inquiry on the knowledge of nurses about suction was given to the nurses, and they were asked to apply suction according to the guidelines they were given. All the obtained data were evaluated by statistical package for the social sciences (SPSS) for Windows 14.0. In summary, 33.8% (n = 22) of the patients were between ages 1 and 12 months, and 64.6% (n = 42) were boys. Although group 2 patients (patient who is in experimental group) had higher scores on the Wong-Baker faces pain rating and Face, Legs, Activity, Cry, Consolability scales, no statistical difference was found between the two groups (p > .05). Patients who received bolus doses of analgesia and sedative drugs had lower Wong-Baker faces pain rating (4.38 ± 0.96; n = 4) and Face, Legs, Activity, Cry, Consolability scores (4.61 ± 1.94; n = 4) (p > .05). According to these findings, the patients were distressed because of the pain related with suction. Therefore, it is recommended that suction guidelines be used in PICUs during ETS.
Related Concept Videos
Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
Tracheostomy Suctioning II: Procedure
Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
Assessment of apical pulse
Assessing the apical pulse is a critical nursing procedure, particularly indicated for:
Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
Tracheostomy Suctioning I: Pre-Procedural Steps
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...

