FOCUS Fall
Bally’s Las Vegas
Oct. 1-3, 2013
Andy Brown RRT-NPS
Clinical Product Manager
Precision Medical Inc.
Northampton, PA
Suction Devices in the Hospital
Myths and Facts
Welcome
Disclosure
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I am the Clinical Product Manager for Precision Medical
Precision Medical manufactures suction equipment
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Home
Hospitals
I have no other conflicts of interest
A Brief History Of Suction
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Airway suction was once described as a “surprisingly
simple technique” (Thompson, 1936) .
In 1959, Boba et al studied the effects of
endotracheal suctioning in paralysed patients. They
reported that severe hypoxia resulted from
suctioning for one minute.
Shumacker et al (1951), Keown (1960) and Marx et al
(1968) reported cardiac arrest associated with
endotracheal suction.
A Brief History Of Suction
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Rosen and Hillard (1962) stated that deaths during
suctioning procedures have not been reported as often as
personal inquiries indicate that they happen.
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“cardiac arrest may arise from the stimulation of respiratory
tract reflexes,”
In 1984, Kergin et al., Using oximetry, again reported
reduction in blood oxygen saturation during suctioning.
Gas System Risk Levels and
Requirements
3.3.90 Level 1 Medical Piped Gas and Vacuum Systems.
Systems serving occupancies where interruption of the piped medical
gas and vacuum system would place patients in imminent danger of
morbidity or mortality.
3.3.91 Level 1 Vacuum System. A system consisting of centralvacuum-producing equipment with pressure and operating controls,
shutoff valves, alarm warning system, gauges, and a network of piping
extending to and terminating with suitable station inlets at locations
where patient suction could be required.
3.3.92 Level 2 Medical Piped Gas and Vacuum Systems.
Systems serving occupancies
where interruption of the piped medical
gas and vacuum system would place patients
at manageable risk of morbidity or mortality.
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6
Gas System Risk Levels and
Requirements (Continued)
3.3.93 Level 3 Compressed Air System. A system of component parts,
including, but not limited to, air compressor, motor, receiver, controls, filters,
dryers, valves, and piping, that delivers compressed air <1100 kPa (<160 psi
gauge) to power devices (hand pieces, syringe, cleaning devices, etc.) as a power
source.
3.3.94 Level 3 Piped Gas Systems. Systems serving occupancies where
interruption of the piped medical gas would terminate procedures but would
not place patients at risk of morbidity or mortality.
3.3.95 Level 3 Piped Vacuum System. A Level 3 vacuum distribution
system that can be either a wet system designed to remove liquids, air-gas, or
solids from the treated area; or a dry system designed to trap liquid and solids
before the service inlet and to accommodate air-gas only through the service
inlet.
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7
Medical Vacuum Outlet Table
Pressure versus Flow (Myth 1)
AARC Clinical Practice Guidelines
Proper Suctioning Technique
Suction Devices - Aspirators
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General Classification
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Emergency – Portable and usually battery powered
Vacuum Regulators – Generally line powered but may be
venturi style
Thoracic – Line powered (cmH2O), may be mobile
Surgical – Line powered
Wound
Suction Devices - Aspirators
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Purpose
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Removal of obstructions from the airway
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Secretions
Vomitous
Blood
Removal of blood or fluids from open wounds or from a
surgical field
Evacuate air or fluid from the pleural space
Suction Devices – Emergency Aspirator
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Useful in pre-hospital or within the hospital where line
vacuum is not available
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Components
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Battery powered unit with electrical backup/charger
Suction tubing
Collection canister
Carrying case
Catheters
Diaphragm Pump
Rotary-Vane Pump
Vacuum Regulators
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Typically line powered units (venturi) more commonly
found in institutions used for multiple applications
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Continuous
Continuous/Intermittent
Thoracic
Surgical
Vacuum Regulators
Continuous Vacuum Regulator Use
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Used for continuously removing air or fluid from the
patient
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Continuous suction is the most common form of suction used
on patients
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Airway
Thoracic
Pleural
Surgical
Intermittent Vacuum Regulator Use
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A client’s condition may warrant special interventions to
decompress the gastrointestinal tract. GI intubation is one of these
interventions. Paralytic ileus is one of the conditions that would
warrant intubation
Conditions may warrant the use of intermittent suction and gastric
drainage.
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Necrotizing enterocolitis (NEC)
Obstruction
GERD
Inflammatory bowel disease
Post surgical aspiration prevention
Trauma
Facilitating Tube Drainage
 Because
gastric and intestinal fluid
must move against gravity to be
removed suction is required
 Low Suction
 High Suction
 Intermittent Suction
 Constant Suction
 Proper functioning