![]() ![]() The answer is A: bubbling Coarse crackles can be described as sounding like gurgling or bubbling that does not go away with coughing.Ħ. What descriptive word could the nurse use to describe the sound of coarse crackles? Coarse crackles tend to occur in the larger airways such as the bronchi.ĥ. Where are coarse crackles usually located in the respiratory system? Are coarse crackles considered a continuous or discontinuous adventitious lung sound?Ĥ. True or False: Coarse crackles are shorter and softer than fine crackles.Īnswer: FALSE…fine crackles are shorter and softer than coarse crackles.ģ. Coarse crackles occur around the beginning of inspiration and can extend to expiration, and is longer than fine crackles.Ģ. When would the nurse expect to auscultate coarse crackles during the respiratory cycle? ©2015 American Association of Critical-Care Nurses.1. Despite common practice, assessment of lung sounds to identify the need for suctioning is not supported. Patients receiving mechanical ventilation should be routinely assessed for coarse crackles over the trachea, the most common indicator for endotracheal suctioning. ![]() Cues resolved and physiological parameters improved after suctioning. The most frequent cues were crackles over the trachea (88%), sawtooth waveform (33%), coughing (29%), and visible secretions (5%). Three patients had no cues identified but had 1.0 mL or more of secretions. The median time to endotracheal suctioning was 2 hours, and a mean of 4.4 mL of secretions was removed. ![]() Mean age was 51 years, and mean duration of mechanical ventilation was 7.5 days. Most patients were male (62%) and white (93%). Secretions were collected, measured, and weighed. Endotracheal suctioning was done when cues were detected or 4 hours after baseline suctioning. After baseline endotracheal suctioning with a closed-system device, patients were assessed hourly up to 4 hours for guideline-based cues for endotracheal suctioning and lung sounds were auscultated. To determine clinical cues for endotracheal suctioning in patients who require mechanical ventilation.Ī descriptive study of 42 adult patients receiving mechanical ventilation. Guidelines recommend coarse crackles over the trachea and/or the presence of a sawtooth pattern on the flow-volume loop of the ventilator waveform as the best indicators. Suzanne Ashworth is a clinical nurse specialist in neurological critical care at Orlando Regional Medical Center, Orlando, Florida.Ĭritically ill patients who need mechanical ventilation require endotracheal suctioning. Melody Bennett is a member of the adjunct faculty at the University of Central Florida and a clinical research coordinator at Orlando Health. 2 Mary Lou Sole is Orlando Health Distinguished Professor and Pegasus Professor, University of Central Florida, College of Nursing, Orlando, Florida, and a research scientist at Orlando Health, Orlando, Florida. Suzanne Ashworth is a clinical nurse specialist in neurological critical care at Orlando Regional Medical Center, Orlando, Florida. 1 Mary Lou Sole is Orlando Health Distinguished Professor and Pegasus Professor, University of Central Florida, College of Nursing, Orlando, Florida, and a research scientist at Orlando Health, Orlando, Florida. ![]()
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