Portable Suction Research Articles

Audit of Tracheostomy Care Practices in a Nigerian Tertiary Neurosurgical Intensive Care Unit According to Published Guidelines.

Chest infections are a frequently encountered problem in patients admitted to the intensive care unit (ICU), more so in tracheostomised patients. This study aimed to audit the tracheostomy care practices in patients with neurosurgical pathologies in the ICUof Wellington Clinics Abuja, a tertiary neurosurgical hospital in Nigeria. We conducted a closed-loop audit with mixed methods involving analysis of 24 patients who had tracheostomy within the first two weeks of neurosurgical pathology at a tertiary neurosurgical hospital and semi-structured interviews to determine tracheostomy care practices among the primary caregivers - nurses, intensivists, and doctors. Of the 161 ICU admissions in the first cycle, 22 patients received tracheostomy, 16 met the eligibility criteria. At re-audit (second cycle), eight of 40 patients met the criteria. All the patients received open suctioning through a dual cannula-cuffed tracheostomy tube and had independent portable suction units. In the baseline audit (first cycle), suction catheters were reused for 12-24 hours in each patient and were stored in varying combinations of normal saline and Savlon antiseptic (5 mg of cetrimide (0.5% w/w) and 1 mg of chlorhexidine digluconate (0.1% w/w)). The frequency, technique, and assessment of the need for airway suctioning were inconsistent among caregivers interviewed. All 16 patients had at least one episode of pneumonia, 10 patients had a second episode, and two patients had > two episodes. One mortality was recorded directly attributable to the complications of pneumonia. While in the re-audit, with adherence to recommendations, three patients suffered one episode of pneumonia and only one had a second episode. No mortality was recorded. A standard practice guideline wasnecessary for tracheostomy care in our ICU. In low-resource settings, stated recommendations such as single-use suction catheters and improved hygienic practices can reducerates of pneumonia in tracheostomised patients.

Continued Development and Testing of a Novel Steerable Chest Tube, Extendable Infusion Cannula, and Portable Suction-Infusion Pump for Use in Austere and Transport Environments to Prevent Retained Hemothorax.

With blunt and penetrating trauma to the chest, warfighters frequently suffer from hemothorax. Optimal management requires the placement of a chest tube to evacuate the blood. Malposition of the tube may be a causative factor of inadequate drainage (retained hemothorax). As a potential solution, we developed a previously reported steerable chest tube allowing accurate placement into a desired location to enhance effectiveness. To provide assisted aspiration, we developed a portable, battery-operated suction device capable of simultaneous or sequential infusion. This report details the ongoing progress of this project. Updated steerable tube and pump prototypes were designed and produced. The tubes were tested for feasibility in two pigs and one cadaver by fluoroscopically comparing tip positions after insertion by a number of providers. Measured drainage volumes comparing standard vs. steerable tubes after pleural infusion of 1,000 mL of saline in two pigs were compared. Testing of the pump focused on the accuracy of suction and volume functions. The steerable tube prototype consists of sequentially bonded segments of differing flexibility and an ergonomic tensioning handle. The portable suction pump accurately provides up to 80 cmH2O of suction, an infusion capability of up to 10 mL/min, and a 950 mL removable reservoir canister. After minimal training, providers easily and repeatedly placed the tip of the steerable tube in the lateral diaphragmatic sulcus in animals and cadavers. Arc was limited to the distal segment. Compared to a standard tube, the steerable tube placed along the diaphragm improved pleural fluid drainage volumes by 17%, although this did not reach statistical significance in six trials. These new prototypes represent substantial improvements and were performed according to expectations. We believe that this steerable chest tube and portable suction-infusion pump can be effectively used for warfighters with chest injuries in austere environments.

Performance of portable emergency suction devices in pre-hospital conditions: a pilot study in the fire brigade.

The study was conducted in organizational units of the State Fire Service (24-hour officers). The research consisted in carrying out the task with the use of three models of mobile rescue aspirators (manual, hand-foot, battery). Each participating firefighter had the task of sucking up an equal amount of fluid (100 ml, respectively) with each model of an aspirator. The test fluid was water at room temperature in a homogeneous 1:1 mixture with sugar (increased viscosity and density, simulated real conditions). Immediately after three suction attempts (with measured suction time), each officer completed a questionnaire on the three models used. Descriptive statistics were used to characterize the variables. The following measures were calculated for the variables: mean (M) and standard deviation (SD), minimum, maximum. The following measures were calculated for categorical variables: number (n) and frequency (%). 184 officers (182 M and 2 F) took part in the study, including commanders 18.43%, rescuers 65.22%, drivers 16.30%. In the study area 1,609 officers serve in the combat division as at the end of 2021. The studied group accounts for 11.43%. Age of respondents M 34.04 SD 8.24 Min 21 Max 52, length of service M 8.48, SD 7.20 Min 1, Max 25. The longest mean time of completing the task was recorded for model 2 (hand-foot) and it was 6.77 sec. SFS officers highly appreciated the usefulness and effectiveness of the battery-operated automatic aspirator. This assessment may contribute to the widespread introduction of such a model to rescue sets in the SFS. Time of performing the task by mode 1 was significantly longer by elderly people. People with experience with the model 1 during rescue and firefighting operations had a significantly shorter time of performing the task with the use of the model 2. According to the subjective assessment of firefighters, the most effective is model 3, which is confirmed by the suction time obtained at the work station.

Robust superhydrophobic magnetic melamine sponge inspired by lotus leaf surface for efficient continuous oil–water separation

Inspired by the oily surface layer and hierarchical structure on the lotus leaf surface, a magnetic sponge with robust superhydrophobicity (water contact angle up to 155°) and surface protection was synthesized by one-pot solvothermal method by introducing (3-Mercaptopropyl)trimethoxysilane into the melamine sponge. After hydrolysis and self-polymerization, (3-Mercaptopropyl)trimethoxysilane can grow as a low surface energy polysiloxane coating on the surface of sponges and magnetic particles. It not only provides a hydrophobic surface layer for sponges, but also this cooperation of micro-submicron-nanostructure from micron sponge skeleton, submicron Fe3O4 particles and nanoscale polysiloxane builds rough surfaces at multiple scales. Based on the triadic Koch curve model, the theory of superhydrophobic surface is elucidated in detail from the surface fractal behavior, fractal dimension, and surface composition. The sponge can be integrated into a negative pressure system as a filter element for continuous and efficient oil–water separation. The formed polysiloxane can not only provide protection for the sponge skeleton and magnetic particles, but also provide strong cross-linking between the two materials, which can effectively resist the damage to the functional structure caused by oil erosion. In addition, a conceptual diagram of a portable oil suction device similar to a vacuum cleaner was proposed. Combining the basic theory of robust superhydrophobic surface and innovatively clarifying the influence of filter element structure on oil–water separation efficiency from the perspective of interface force, it is expected to bring more practical and potential ideas for the design of a portable vacuum cleaner-like oil–water separation device.

Instavac Portable Suction Pump

Biomedical Safety & Standards: April 01, 2022 - Volume 52 - Issue 6 - p 43 doi: 10.1097/01.BMSAS.0000824328.79962.9b

A Market Review of Available Airway Suction Technology.

Airway injuries are the second leading cause of potentially survivable battlefield death and often require airway management strategies. Airway suction, the act of using negative pressure in a patient's upper airway, removes debris that can prevent respiration, decreases possible aspiration risks, and allows clearer viewing of the airway for intubation. The most important characteristics for a portable airway suction device for prehospital combat care are portability, strong suction, and ease of use. This market review searched academic papers, military publications, Google searches, and Amazon to identify devices. The search included specific characteristics that would increase the likelihood that the devices would be suitable for battlefield use including weight, size, battery life, noise emission, canister size, tubing, and suction power. Sixty portable airway suction devices were resulted, 31 of which met inclusion criteria - 11 manually powered devices and 20 battery-operated devices. One type of manual suction pump was a bag-like design with a squeezable suction pump that was extremely lightweight but had limited suction capabilities (vacuum pressure of 100mmHg). Another type of manual suction pump had a trigger-like design which is pulled back to create suction with a firm collection canister that had increased suction capabilities (vacuum pressures of 188-600mmHg), though still less than the battery operated, and was slightly heavier (0.23-0.458kg). Battery-operated devices had increased suction capabilities and were easier to use, but they were larger and weighed more (1.18-11.0kg). Future research should work to lighten and debulk battery-operated suction devices with high suction performance.

Portable Medical Suction and Aspirator Devices: Are the Design and Performance Standards Relevant?

Airway clearance refers to the clearing of any airway blockage caused due to foreign objects such as mud, gravel, and biomaterials such as blood, vomit, or teeth fragments using the technology of choice, portable suction devices. Currently available devices are either too heavy and bulky to be carried, or insufficiently powered to be useful despite being in accordance with the ISO 10079-1 standards. When applied to portable suction, the design and testing standards lack clinical relevancy, which is evidenced by how available portable suction devices are sparingly used in pre-hospital situations. Lack of clinical relevancy despite being in accordance with design/manufacturing standards arise due to little if any collaboration between those developing clinical standards and the bodies that maintain design and manufacturing standards. An updated set of standards is required that accurately reflects evidence-based requirements and specifications, which should promote valid, rational, and relevant engineering designs and manufacturing standards in consideration of the unique scenarios facing prehospital casualty care. This paper aims to critically review the existing standards for portable suction devices and propose modifications based on the evidence and requirements, especially for civilian prehospital and combat casualty care situations.

Use of a Novel Portable Non-powered Suction Device in Patients With Oropharyngeal Dysphagia During a Choking Emergency.

Choking remains a leading cause of accidental death and morbidity worldwide. Currently, there is no device to assist in the resuscitation of a choking victim when standard maneuvers fail. A novel portable non-powered suction device (LifeVac; LifeVac LLC, Nesconset, NY) has been developed and may have potential use in patients with oropharyngeal dysphagia who are at increased risk of choking. The device is FDA registered and distributed worldwide. This case series provides a summary of self-reported data regarding the use of the suction device in adult patients with oropharyngeal dysphagia during real-world choking emergencies recorded between January 2014 and July 2020. Over a 6-year monitoring period the device has been reported to be successful in the resuscitation of 38 out of 39 patients with oropharyngeal dysphagia during choking emergencies. Although the obstruction was removed with the device from the 39th patient, resuscitation was not successful and he succumbed to his injuries. This portable, non-powered suction device may be useful in resuscitating patients with oropharyngeal dysphagia who are choking. The reported cases describe successful use of the device in real-world settings with minimal risk. Resuscitating patients with oropharyngeal dysphagia using this device may be a viable option when abdominal thrusts or back blows fail to resolve a choking emergency.

Clinical efficacy of digital chest drainage system in cardiac valve surgery.

The portable digitalized suction was used widely in thoracic surgery. The aim of the study was to access the early outcomes of using the portable digitalized suction system after cardiac surgery. We invested 80 patients including 30 women (mean age 72.7 ± 9.2years) who underwent cardiac surgery at our hospital, excluded coronary artery bypass grafting only, with or only aortic surgery, emergency operation, and patients with hemodialysis. Patients were categorized as those treated with digital chest drainage system (DCS group, n = 38) or analog chest drainage system (ACS group, n = 42), and the following data were analyzed in two groups. The primary endpoint was the duration of chest drainage, and the secondary endpoints were the rate of drainage-related complications and the length of hospitalization. The duration of drainage was significantly shorter in the DCS group (ACS vs. DCS = 94.8 ± 31.5 vs. 81.1 ± 20.6h, p = 0.036). The duration needed for rehabilitation completion was significantly shorter in the DCS group (ACS vs. DCS = 10.7 ± 1.2 vs. 9.6 ± 1.5days, p = 0.047), and the length of hospitalization was significantly shorter in the DCS group (ACS vs. DCS = 21.9 ± 5.3 vs. 18.8 ± 7.2days, p = 0.031). This study provided evidence that DCS might be effective for patients who underwent cardiac valve surgery.

Liposuction Using Wall Suction and Portable Suction in the Treatment of Gynecomastia

Although there are a variety of advanced liposuction techniques for body contouring, they all come with financial burden and are not available in all hospitals. This article describes a method of using hospital wall suction and portable suction as an alternative for liposuction machine in the management of gynecomastia. Twenty-three patients with gynecomastia from 2015 to 2020 were included. Patients were classified by Simon et al.’s grades of gynecomastia and by the four categories on the Breast Imaging Reporting and Data System. Wall and portable suction–assisted liposuction was performed. Further follow-up of complications was monitored for up to 2 years. The satisfaction of patients was measured with the Breast Evaluation Questionnaire (BEQ), and the objective improvement was evaluated by three observers. Among the 23 patients (45 breasts) treated using this technique, there were complications in a total of three patients. The average operative time was 65 min (range, 40 to 80 min). The patients’ mean (standard deviation (SD)) overall satisfaction score was 4.13 (0.5). The mean (SD) BEQ for all variables increased from a “dissatisfied” score of 1.8 (0.2) preoperatively to a “satisfied” score of 4.0 (0.1) postoperatively (p < 0.001). In the objective evaluation, the analysis of variance test demonstrated that the postoperative results showed significant improvement (p = 0.002). Wall suction and portable suction–assisted liposuction is not only a safe and satisfying technique for the treatment of patients with gynecomastia but also a convenient and cost-effective technique for surgeons who cannot avail or afford liposuction devices.

Resuscitation Of Pediatric Choking Victims Using The Lifevac, A Novel Portable Non-Powered Suction Device: Worldwide Results

Resuscitation Of Pediatric Choking Victims Using The Lifevac, A Novel Portable Non-Powered Suction Device: Worldwide Results

A laboratory study to assess the formation of effluent volatile compounds and disinfection by-products during chemomechanical preparation of infected root canals and application of activated carbon for their removal.

To assess in a laboratory setting using extracted teeth the formation of volatile compounds (VOCs) and disinfection by-products (DBPs) in effluent aliquots, during chemomechanical preparation of artificially infected root canal specimens, and determine the role of silver-impregnated activated carbon (Ag-AC) in their removal. Single-rooted human teeth were decoronated to obtain 15mm-long root specimens and a nutrient-stressed multispecies biofilm was grown in the root canals. Specimens were randomly assigned into three groups [Group 1; instrumentation with rotary files and irrigation with sterile saline, Groups 2 and 3; instrumentation with rotary files and irrigation with 2.5% NaOCl and 17% EDTA]. A portable medical suction device was used to collect the effluent aliquots during root canal irrigation. In Groups 1 and 2, the reaction products of the collected effluents were analysed by selected ion flow tube mass spectrometry (SIFT-MS). The effluents from Group 3 were treated with Ag-AC prior to SIFT-MS analysis, to assess the removal capacity of Ag-AC against the reaction products. The synthesis of Ag-AC was characterized with scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDS). Two-way analysis of variance (anova) with post hoc Tukey tests was used for data analysis and determination of a significant difference (P<0.05). In Group 1, effluent VOCs and DBPs were detectable at very low levels. In Group 2, the collected effluent aliquots released high concentrations of methanol, propanol, ammonia, chloroform and formaldehyde, which were significantly greater compared to Group 1 (P<0.001). SEM/EDS analysis confirmed impregnation of Ag within the AC matrix. The treatment of effluent aliquots with Ag-AC (Group 3) resulted in a significant reduction in concentrations of acetone, acetic acid, propanol, acetaldehyde, acetonitrile and chloroform, compared to Group 2 (P<0.001). The concentration levels of ethanol, methanol, ammonia and formaldehyde remained unaffected (P>0.05). In this laboratory setting using extracted human teeth, the chemomechanical preparation of artificially infected root canals resulted in the formation of toxic VOCs and DBPs as effluent suspensions. Their release during aspiration with dental suction indicates that potential environmental hazards should be investigated. The use of silver-impregnated activated carbon had potential for the point-of-use treatment of post-irrigation effluent aliquots.

Airway Clearance Using Suction Devices in Prehospital Combat Casualty Care: A Systematic Review.

Airway management is at the forefront for combat medics dealing with battlefield trauma. For military service members, compromised airways are the second leading cause of potentially survivable death on the battlefield, accounting for one in ten preventable combat deaths. Effective suction is a critical component of airway clearance. However, currently available devices are too heavy and bulky to be carried by combat medics and are insufficiently powered. The industry has not responded to the need, with companies continuing to produce models using 1970s technology. A literature review was completed with the assistance of a librarian. The databases searched included: Biomedical Research Database (BRD), Computer Retrieval of Information of Scientific Projects (CRISP), Federal Research in Progress (FEDRIP), Defense Technical Information Center (DTIC), Pub Med/Medline, and OVID. Additionally, a Google Scholar search was performed to identify nonstandard sources. After screening, a total of 40 articles were used. There were no randomized controlled trials or other high-quality evidence that addressed the issues; there was limited peer-reviewed literature on the use, effectiveness, adverse effects, and safety of suction for use in combat casualty care. A review of the available literature revealed no standards, either proposed, validated, or accepted, for the safety or avoidance of adverse effects for portable suction device use in combat casualty care. Similarly, there are no accepted standards to guide the safe use and anticipated adverse effects of suction for use in prehospital combat or emergency care. Nevertheless, there are meaningful data that can be extracted from the few studies available combined with non-clinical studies, narrative reviews and case reports, and expert opinions.

Portable compact suction pad unit for parallel grippers

This paper proposes a portable compact suction pad unit for the parallel grippers of a mobile manipulation robot to place items for product display. In addition, this paper includes verification of the unit’s mechanism. Given that robots have to hold various items, we propose an operation method by which the parallel gripper holding the compact suction pad unit switches between a pinching mode and a vacuum suction mode depending on the item being placed. The compact suction pad unit is self-contained, with all the devices necessary for the suction operation inside the unit. The suction operation is switched on and off wirelessly by an external host system controller. The compact suction pad unit produced a suction force of about 5.6 N at an allowable inclination angle of 15°. We demonstrated in a competition that our proposed operation method of the compact suction pad unit is useful by having it place a beverage in a cup with lid and a boxed lunch.

Characterization of a Novel Emergency Suction Device for Combat Medics

Abstract Airway clearance is a foremost priority for combat medics dealing with battlefield trauma. This life saving intervention starts with inspection, clearing any obstructions from the airway, and if necessary, placement of an endotracheal tube to secure the airway. For inspecting and clearing the airway under complicated battlefield conditions, combat medics require a portable suction device that is compact, lightweight, rugged, and capable of rapidly evacuating a mix of liquid and solid particles, which may include bone fragments or broken teeth. While several portable suction devices are available on the market, none were developed specifically for the combat environment. Interviews with combat medics and other relevant personnel revealed that currently available systems are limited in utility to the point of often being intentionally omitted from their kits. In addition, these discussions identified several design specifications for a desired system, such as size (30 × 10 × 10 cm), weight (≤1 kg), fluid flowrate (1 L/min), and canister size (0.5–1 L), among others. This research focused on developing and characterizing a functional prototype within the specified design criteria. After designing and fabricating the device, evacuation of water, blood mimicking solution, and simulated vomitus solution were assessed. In addition, a comparative analysis was carried out between the five different commercially available suction catheters by assessing fluid flow rate and obstruction resistance. The results demonstrate the first proof-of-concept characterization for a novel combat-oriented suction system and provide a basis for comparing the performance of suction systems and catheters used in airway management.

Portable Suction Pump Battery

Biomedical Safety & Standards 48(20):p 156, November 15, 2018. | DOI: 10.1097/01.BMSAS.0000547576.00051.14

Through and through suturing vs. window resection method in surgical management of seroma pinna: a comparative study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Seroma pinna is a collection of fluid between the auricular cartilage and the perichondrium. Seromas can occur spontaneously or after surgery or trauma. Depending on the nature of swellings and the symptoms, they can be distinguished from other conditions of the pinna. Successful treatment is challenging because of high rate of recurrence. Usual treatment used to consist of aspiration of the fluid and pressure bandage. Methods include using buttons as pressure splints, excising a piece of cartilage and perichondrium to cure recurrent seromas&lt;sup&gt;4&lt;/sup&gt;,placement of a continuous portable suction drain has also been advised, suturing through and though after aspiration.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In the first group of patients through and through suturing was done and in the second group window resection was done. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The recurrence rate was 5% for the first group patients while 20% for the second group. The percentage of development of perichondritis was 5% for group A and 15% for group B.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The method put forward in this study is a simple and effective way for its management. The avoidance of dressing is a positive factor and positive factor is that it can be done on an OPD basis.&lt;/p&gt;

Successful Resuscitation of Choking Victims Using a Lifevac, a Non-powered Portable Suction Device: Real World Experience: 2017 Presidential Poster Award

Choking is a leading cause of accidental death worldwide and in the Uited States. Patients with oropharyngeal dysphagia are at a high risk for aspiration of food and thus, choking. Although there have been great technological advances, currently, there is no approved device to assist in the resuscitation of a choking victim when abdominal thrusts fail. Recently, a portable, non powered suction device called Lifevac has been developed and introduced globally. This device consists of a one way valve and a plunger attached to a standard face mask. When the plunger is pushed down, air escapes out the sides of the valve and not into the victims airway; when the plunger is pulled back, negative pressure is generated and it suctions out the lodged material. Here we report several real-life cases in which this apparatus has been successfully used to resuscitate a choking victim. A care home in Wales obtained several Lifevac devices for their residents. During lunch, a resident of this care home began choking on a piece of meat, lost consciousness, began turning blue. A nurse in the home attempted usual methods of assistance without any success. Therefore, the Lifevac device was used according to directions, and with one pull, the meat piece was dislodged. A physician was then called. the physician examined the patient and noted no adverse effects. Additionally, no further intervention was required. The same care home reported that 1 week later, another patient suffered a similar episode and the device was again successfully used to dislodge a meat piece through suctioning into the unit. In addition, a Lifevac device was obtained by a family in Idaho and was kept at home in case of a choking emergency. On April 23, 2017, a woman in her late 60s with no underlying medical condition began choking at the dinner table on a meat piece. She was unable to speak and was wheezing. Her son unsuccessfully attempted the Heimlich maneuver; thus the Lifevac device was used as per instructions, and with one pull the meat piece was dislodged into her mouth. She did not require further medical attention. These dramatic real-life case reports demonstrate the utility of this non powered suction device. Certainly, these testimonials show that lives were saved and major morbidity and mortality avoided. Further studies are urgently needed as there is a need for such a suction device when abdominal thrusts fail to address choking.Figure

Safety and Quality Concern of In-Home Suction Equipment Failure Over Time

Portable suction machines are widely implemented in both clinical and home care settings. Two identical new machines were tested at 3 different levels of pressure settings operating at intermittent intervals. The study uncovered that noncalibrated portable suction triggers an additional 17% higher suction pressure than the actual most efficient and desired pressure setting. There are statistically significant differences between the calibrated suction machine and noncalibrated suction machine at 3 levels of settings: 80, 100, and 120 mm Hg. This emphasizes the need for fundamental safety redesign of clinical calibration measures for clinical engineering.

An Affordable Custom-Built Negative Pressure Wound Therapy

Negative pressure wound therapy (NPWT) is a wellestablished and effective method for treating complex wounds. However, this modality of treatment may not be available in limited resource countries due to the high cost. We describe a simple and cheap method of NPWT using gauze swabs, a naso-gastric tube, adhesive occlusive drape and a central or portable suction machine.Key words: Negative Pressure, Wound Therapy