OBJECTIVE To examine the current suctioning practices nationally of experienced pediatric intensive care unit (PICU) nurses. METHODS A written survey method was used for this descriptive study. METHODS All PICUs in the 92 hospitals listed in the 1991 National Association of Children's Hospitals and Related Institutions directory. METHODS Staff nurses with more than 3 years experience were requested to complete the questionnaire in relation to their endotracheal suctioning practices of PICU patients. RESULTS The questionnaire was returned by 80 (90%) PICUs. A wide range of suctioning techniques were used. Most respondents reported hyperoxygenation, hyperventilation, and/or hyperinflation of the patient's respiratory system before suctioning. Nursing judgment and the patient's clinical condition were used to determine when a suctioning procedure was needed. Most respondents (71%) indicated inserting the suction catheter until resistance was met. Normal saline-solution irrigant was used by all but one respondent. A manual resuscitation bag was used routinely during suctioning. Eighty percent of respondents reported that few patients displayed an adverse response to the suctioning procedure. CONCLUSIONS The study should be replicated with direct observations of actual PICU suctioning practices. Suctioning techniques should be examined in relation to specific groups of PICU patients. Further research is needed to determine the optimal practice for rates of hyperventilation, percentage of oxygen increase during hyperoxygenation, and pressure increase during hyperinflation.