The use of normal saline installation in the intensive care unit by physiotherapists. a review of practice in New Zealand
Normal saline installation is used by health professionals during the treatment of intubated patients within the intensive care unit, usually to enhance sputum yield. Its use is controversial; detrimental effects have been documented and evidence of any benefit is limited. Studies have suggested routine use be discontinued. The aim of this study was to investigate the use of normal saline installation in the intensive care unit by physiotherapists throughout New Zealand. A purpose designed postal survey was administered to the senior physiotherapist in all intensive care units in New Zealand (n = 25). A response rate of 76% (n = 19) was obtained. Installation of normal saline was reported as being practised in 78.9% (n = 15) of hospitals, however physiotherapists reported being involved in this practise in only 52.6% (n = 10) of cases. Of the respondents who reported never using normal saline installation (47.4%, n = 9) the majority of these based this on a lack of supporting evidence (36.8%, n = 7). Whilst most respondents reported having the autonomy to use normal saline installation with their patients, three respondents (15.8%) reported requiring permission from an intensivist before use. A written protocol for use of normal saline installation was rare with only 15.8% (n = 3) of respondents reporting using these. Techniques used for administering normal saline were ascertained. Despite a lack of supporting evidence of any benefit, normal saline installation continues to be widely practised in intubated patients in the intensive care unit in New Zealand.