I read with interest Faulds and Murray’s findings [1] regarding inadequacy of resuscitation suction equipment. Recent failure of both wall-mounted and portable suction equipment at a cardiac arrest prompted a similar audit of equipment at our hospital. A total of 222 units were tested: this encompassed all portable and wall-mounted suction units excluding neonatal areas.

Our results overall were slightly more encouraging, with 59% of units immediately ready for use (52% when critical care areas were excluded). Eighty three per cent (20/24) of portable units were functioning and correctly set up. These compare to 32%, 24% and 56% respectively in the South Yorkshire hospitals. Important considerations include that in the smaller district general hospital the proportion of suction units found in the emergency department, medical admissions unit and paediatric wards will be higher, and that a reduced number of portable units permits regular checking by the resuscitation department.

Unfortunately, on surgical wards only 48% (34/71) were ready, and on medical wards only 22% (13/60). Another concern was that 19 units failed to reach the required 500 mmHg of negative pressure in 10 seconds when occluded – seven of these due to damaged suction liners but the others due to vacuum regulator faults. Spotting these faults, and also detecting low flows through an unoccluded system, requires an understanding of suction equipment and more extensive testing, than merely turning the system on and checking for a hissing sound [2].

I agree with Faulds and Murray’s conclusions regarding improvement, in particular designated responsibility and simple training. We are now trying to improve these aspects in our hospital. We have created a poster as an educational resource for ward staff. In areas where suction is checked by ward nurses either on a daily basis or when a patient is discharged, I found over 92% ready to use.

Angus McKnight

Anaesthetics Department, Horton Hospital
Banbury, Oxfordshire OX16 9AL
Email: angus.mcknight@doctors.org.uk

References

[1] Faulds MC, Murray RJ. An audit of resuscitation suction equipment in clinical areas at six hospitals across South Yorkshire. Anaesthesia 2010; 65: 103-104.

[2] Meagher AP, Hugh TB, Li B, Montano SR. Physics and function of operating room suction. Australian and New Zealand Journal of Surgery 1991; 61: 687-691.