Suction machines- Applications and Maintenance

Suction machines (also known as aspirators) are used to remove unwanted fluid from body cavities. They are found in operating theatres, delivery suites, ENT and emergency departments. Smaller specialised suctions are used in dental departments.
How it works
Suction is generated by a pump. This is normally an electrically powered motor, but manually powered versions are also often found. The pump generates a suction that draws air from a bottle. The reduced pressure in this bottle then draws the fluid from the patient via a tube. The fluid remains in the bottle until disposal is possible. A valve prevents fluid from passing into the motor itself.

1. Let’s Learn Health Technology in Health Technology Management Series Topic-Suction Machines Health technology  is defined by the World  Health  Organization as the "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a  health  problem and improve quality of lives“

2. SUCTION MACHINE -Introduction and Maintenance Health Technology Management Series By Dr. S.B.Sinha - Ex. President Biomedical Engineering Society of India

3. T opics Introduction Uses Indication Principles of operation Diagrams Applications Types of suction pumps Safety Operation Preventive maintenance Common failure modes Basic troubleshooting

4. SUCTION MACHINE Introduction In medicine, devices are sometimes necessary to create suction. Suction may be used to clear the airway of blood, saliva, vomit, or other secretions so that a patient may breathe. Suctioning can prevent pulmonary aspiration, which can lead to lung infections. In pulmonary hygiene, suction is used to remove fluids from the airways , to facilitate breathing and prevent growth of microorganisms.

5. SUCTION MACHINE Introduction Suction machines are appliances that are A portable suction unit can prevent pulmonary aspiration and facilitate breathing. Suction machine supplies include bacteria filters, collection canisters, and aspirator tubing kits. Suctioning is a procedure that removes excess secretions from the mouth and throat (oropharynx), from the nose and throat (nasopharnyx), and from the windpipe (trachea) using a mechanical aspiration device (Suction machine).

6. SUCTION MACHINE Introduction Suction devices may be mechanical hand pumps or battery or electrically operated mechanisms. In many hospitals and other health facilities, suction is typically provided by suction regulators, connected to a central medical vacuum supply by way of a pipeline system. The plastic, rigid Yankauer suction tip is one type of tip that may be attached to a suction device. Another is the plastic, nonrigid French or whistle tip catheter.

7. Uses of Suction Machines To remove blood during surgery to clear the area of surgery. To remove the mucous from the throat so that the medical procedures can be carried out without obstruction from mucous. To remove blood that has built up within the skull after an intracranial hemorrhage. T o remove substances such as blood, saliva, mucus, and vomit from a person's airway.

8. Indications for Suctioning: The primary indication for suctioning the patient at home is the patient’s inability to adequately clear the airway by coughing. The need for clearing the airway is evidenced by: More frequent or congested-sounding cough. Visible secretions. Audible gurgling noise while breathing. Suspected aspirations of gastric or upper airway secretions .

9. Operating the Suction Machine: Plug the suction machine into a grounded outlet. Check that the tubing from the machine to the collection jar is on and snug. Check that the lid to the collection jar is closed tightly. Attach the extension tubing to the collection jar. Turn the machine on and kink the extension tubing to block the flow of air. -If the pressure gauge did not move when kinking the tubing, recheck all of your connections. Look for leaks in the system. The lid may not be closed tightly; a tub may not be on properly or the tube in punctured. Look at the pressure gauge. Using the control dial, set the gauge pressure between 15” and 20” of Hg. (for an adult) -An infant or a child will use less pressure. Consult with doctor or call therapist. After the pressure is set, connect the oral suction device (Yankauer Suction Tip) or suction catheter to the suction extension tubing.

10. Equipment and Supplies Needed: Electric or battery powered aspirator with pressure gauge and collection jar with overflow protection . Suction catheters (sized appropriately) Tap water that has been boiled and stored in a closed, clean container. Water needs to be used within 24 hours of boiling to flush the catheter. o Water from the tap that is not boiled will increase the risk of contamination and infection. Clean or sterile disposable gloves A manual resuscitator bag (for hyperinflation of the lungs if medically indicated) An oxygen source (when pre-oxygenation is medically indicated) Sterile normal saline (for instillation when medically indicated) Oral suction device (Yankauer Tonsil Tip) S t erile dis t illed wate r , an d /or rec e ntly b o iled water and clea n ing solution (alcohol or hydrogen peroxide)

11. Preparing the Patient for Suctioning: Whenever possible, the patient should be encouraged to clear the airway by directed cough or other airway clearance techniques. The patient’s response to suctioning during their stay in the acute care or long-term care facility should be made a part of the discharge summary and the health care professional establishing the patient in the home should request this information.

12. Caregiver Training: The caregivers or family members that will be taking care of the patient should be taught the proper suction techniques by qualified hospital personnel. The caregivers or family members should be trained to understand: When it is necessary to suction What type of suctioning is needed (oral vs. nasal tracheal) They should be trained as to when it’s necessary to pre- oxygenate, preform normal saline instillations, use of the resuscitator bag to hyper inflate the lungs and then to deep suction.

13. Suctioning the Patient: 1.Use clean technique during suctioning in the home environment. Clean, non-sterile disposable gloves should be used when performing nasal tracheal deep suctioning. 2.When deep suctioning and using a catheter, do not keep the suction engaged for longer than 5 seconds at a time. 3.At the end of the suctioning event, flush the catheter or tonsil tip by suctioning recently boiled water or distilled water to rinse away mucus, followed by suctioning of air through the device to dry the internal surface and discourage microbial growth. 4.The outer surface of the device may be wiped with alcohol or hydrogen peroxide. The suction catheter or tonsil tip should be allowed to air dry and then stored in a clean, dry area.

14. 5. Replace the suction catheter every 24 hours. Tonsil tips can be boiled, and reused indefinitely. Store the cleaned catheter or tonsil tip so that they are not directly exposed to the air. (Cover with clean, lint-free, paper towels, or store in a clean container). 6.Only suction the patient if they are in distress, or you see or hear ‘wet’ breath sounds. When suctioning, look at the patient. Don’t become so engrossed with the procedure that you become unaware of the patient’s reactions and responses. Remember; don’t actively keep the suction on for more than 5 seconds if using a catheter and performing deep suctioning or for 10 seconds if using the tonsil tip. Let the patient regain their breath.

15. 7.Observe the patient after the suctioning procedure. Are the visible secretions gone? Has the gurgling wet breath sounds stopped or at least greatly diminished? Does the patient appear more comfortable and less distressed? Observe the skin color. (Including the presence or absences of cyanosis). Get into the habit of monitoring the pulse rate before and after suction. Take blood pressure and Oximetry if they have the equipment. Look at the color of the sputum. Are there any changes in the color? Keep doctor’s office informed of the color changes. Is there an odor to the sputum? Again, keep the doctor’s office informed.

16. Cleaning: 1.The suction canister ( cylindrical container ) should be emptied daily and washed, along with the connecting tubing, in hot water and mild dishwashing detergent. Rinse with clean, hot tap water. It is recommended that these items be disinfected daily with a solution of one part white vinegar and 3 parts water. Allow the items to soak for 30 minutes and then rinse with clean, hot tap water. 2.All caregivers should practice reasonable infection control procedure in the home setting. Patients should be protected form visitors and caregivers with active viral and bacterial infections. Or the opposite is true if the patient has yet to be diagnosed with the organism they are carrying which could be spread to others by droplet infection.

17. USES Suction machines used in the homes are usually for helping people with respiratory problems. When a patient or an elderly person is not able to clear the lungs and airway of mucus or serum, then an aspirator can be used to suck out the fluids. Tracheostomy care also involves use of suction machines for removal of secretions from the trachea, nasopharynx and oropharynx thereby maintaining hygiene of the trachea. Suction machines may also be used in cases when someone has a moist cough and is not able to clear secretions from the throat effectively. Components of a suction machine typically include suction pump, connection and patient tubings, disposable canister with lid, rechargeable battery, power cord and bacteria filter. The bacteria filter prevents back flow from the canister and airborne contaminants from entering and damaging the pump.

18. A yankauer is used to aspirate secretions from either a surgical site or a body orifice. Its tip is slightly crooked so as to prevent smooth passage into the throat without fragile tissue being damaged. Selection of suction machines or aspirators stands out for their powerful suction force, reliability and high performance. Portable suction machines are small enough to be fit into a travel bag and can easily be transported anywhere. Suction machines today are lightweight, portable and technologically sophisticated. The most clogged airway can be cleared up quickly through strong, powerful machines returning the patient to the state of comfort. Some of these aspirators have adjustable vacuum pressure needed especially when working with children or an elder people.

19. Suction Pumps

20. Principles of Operation Suction generated using a pump Pump powered by electrical motor or foot pedal Pump moves piston up and down Piston attached to air tight diaphragm Pulls air in from collection container through one-way valve to reduce pressure Reduced pressure draws fluid from patient via tubing Fluid remains in bottle until disposal Valve prevents fluid from passing into motor Motor speed determines suction strength

21. Principles of Operation

22. Diagrams Connection Tubing V acuum Gauge Power S w i tch Power Source In d i cat o r Vacuum R e g u l ator Power Input/Electrical Input Receptacle P ower Cord Co l l e c t i on Conta i ner P at i ent Tubing Input Battery Condition In d i cat o rs Co l l e c t i on Conta i ner Holder Shell Air Intake Barb Vacuum Power In d i cat o r

23. Diagrams Motor Vacuum re g u l ator V acuum gauge Grounding plate Groun d i ng ribbon Electrical input r e c ep tac l e Air intake from collection container Air exhaust from Pump Air intake to pump

24. Diagrams Power Sup p l y Power D i st r i b ut i on Board Batt e ry

25. Applications Used to remove fluid from body cavities Removal of: Surgical fluids in the operative field Mucosal secretions Used in patients with compromised swallowing or coughing

26. Safety ALWAYS use PPE when working with suction pumps Pumps come in direct contact with bodily fluids Wash hands immediately after removing gloves Never fill the collection container more than 75% full Liquid will enter pump Before using, read the owner's manual

27. Operation Position the unit close to patient Plug into AC power (do not use extension cords) Attach first suction tubing from pump suction control to collection bottle outlet Attach second suction tubing to collection bottle inlet

28. Ope r a tion Check all components and connections for tight fit Turn suction pump on (on/off electrical switch) Crimp tubing coming from the collection bottle inlet – In order to test full range of suction Adjust suction to desired level while observing vacuum gauge Initiate suction procedure

29. Preventive Maintenance Daily Clean filters Clean air vents Disinfect jars, tubing, other components that come into contact w/ patient fluids between each use in solution of water, detergent, and disinfectant Change bacteria filter if wet or discolored Check collection bottle/jar for cracks, chips, and other damage Make sure there is a sufficient supply of bacterial filters Check that float valve moves freely 1-3 months Clean or replace air intake filter Clean brushes on motors as necessary Inspect power cord and plug Ensure vacuum works over full range of suction pressures if there is a control/knob Verify that overflow valve (float valve) works properly when container is filled with water Grounding resistance between chassis and ground pin should not exceed 0.5 ohms

30. Common Failures Most common: Clogs, Leaks, Motor Failure Leaks: Tube leak Jar/lid leak (bad O-ring, possibly) Tube blockage or kink Missing/damaged parts: Bad motor Bad power supply No collection bottle No filter Clogged bacterial filter Float valve closes air pathway with full collection jar Insufficient pressure/suction Ventilation grill obstructed Suction control knob is set to a low setting Diaphragm needs cleaning or replacing Brushes need cleaning Motor needs lubrication

31. Basic Trouble- shoot i ng