Normal saline instillation with paediatric endotracheal suction: It's what's always been taught

Introduction: Normal saline instillation (NSI) with endotracheal suction (ETS) is a controversial practice. While there is growing evidence for the abandonment of this practice in mechanically ventilated adults, there is a dearth of quality evidence to support or refute NSI use in intubated children. This lack of guidance has resulted in variable NSI practices in the paediatric intensive care unit (PICU). It is not understood what factors influence a nurse to apply NSI with ETS, or what perceived effect NSI treatment has on patient outcomes.