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Suction Devices in the Hospital

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. I am the Clinical Product Manager for Precision Medical

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Suction Devices in the Hospital

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  1. 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

  2. Welcome

  3. Disclosure • I am the Clinical Product Manager for Precision Medical • Precision Medical manufactures suction equipment • Home • Hospitals • I have no other conflicts of interest

  4. A Brief History Of Suction • 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.

  5. A Brief History Of Suction • Rosen and Hillard (1962) stated that deaths during suctioning procedures have not been reported as often as personal inquiries indicate that they happen. • “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.

  6. 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 central-vacuum-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 patientsat manageable risk of morbidity or mortality.

  7. 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.

  8. Medical Vacuum Outlet Table

  9. Pressure versus Flow (Myth 1)

  10. AARC Clinical Practice GuidelinesProper Suctioning Technique

  11. Suction Devices - Aspirators • General Classification • 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

  12. Suction Devices - Aspirators • Purpose • Removal of obstructions from the airway • Secretions • Vomitous • Blood • Removal of blood or fluids from open wounds or from a surgical field • Evacuate air or fluid from the pleural space

  13. Suction Devices – Emergency Aspirator • Useful in pre-hospital or within the hospital where line vacuum is not available • Components • Battery powered unit with electrical backup/charger • Suction tubing • Collection canister • Carrying case • Catheters

  14. Diaphragm Pump

  15. Rotary-Vane Pump

  16. Vacuum Regulators • Typically line powered units (venturi) more commonly found in institutions used for multiple applications • Continuous • Continuous/Intermittent • Thoracic • Surgical

  17. Vacuum Regulators

  18. Continuous Vacuum Regulator Use • Used for continuously removing air or fluid from the patient • Continuous suction is the most common form of suction used on patients • Airway • Thoracic • Pleural • Surgical

  19. Intermittent Vacuum Regulator Use • 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. • Necrotizing enterocolitis (NEC) • Obstruction • GERD • Inflammatory bowel disease • Post surgical aspiration prevention • Trauma

  20. 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

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