is a necessary and vital procedure done on patients who have an established artificial airway. The goal of is to clear secretions from the patient’s airway and to improve gas exchange (Ackerman, 1993). The instillation of normal saline prior to is a common practice of nurses. Reasons for such practice are varied. One such reason is to loosen and dilute thick, tenacious secretions in the patient’s respiratory tract so that secretions become mobilized and are thus easier to remove during suctioning. Furthermore, such normal saline ins ....