Keith S. Kaye, MD, MPH; Dror Marchaim, MD; Lauren Bentley, MS

Presented at the 37th Annual Meeting of the Association for Professionals in Infection Control and Epidemiology (APIC 2010).

The contemporary literature review does not substantiate the Q24hr recommendation. In vitro work performed shows that a significant risk to the patient exists at 24hrs. Survey results showed that although 93% of facilities have a canister change protocol, only 53% of them change the canister on a Q24hr basis. We suggest that more evidence needs to be obtained for generating canister change protocols. Also, facilities should study their suction circuits to identify any associated risk.

Michael J. Neary, MD;  John J. Hill, BA, RRT-NPS; Bonita Weyrauch, RN, CWS, DNC, CCT; Kevin Klocek, EMT, BSBME, MBA; Randolph Cremer, CBET

Clinical White Paper published by Boehringer Laboratories August 2008

Hospital suction outlets need to provide a minimum of 85 liters per minute of unrestricted airflow to be compliant with established standards. Suction regulators attached to the wall outlets restrict the flow available from these outlets. Only Boehringer suction regulators minimally affect the available flow and deliver maximum suction power, ensuring the most significant ability to remove patient secretions at any suction setting.

Document issued on: March 17, 2015. This document supersedes: “Labeling Reusable Medical Devices for Reprocessing in Health Care Facilities: FDA Reviewer Guidance” issued April 1996.

This guidance provides recommendations for the formulation and scientific validation of reprocessing instructions for reusable medical devices. This guidance document also provides recommendations for the content and review of premarket notification submissions [510(k)], premarket approval (PMA) applications, humanitarian device exemption (HDE) applications, de novo requests and investigational device exemption (IDE) applications, concerning the labeling instructions for reprocessing reusable medical devices.

(Note the HPCS report is not an evaluation. The information it contains is not the result of testing by ECRI Institute’s clinical and engineering personnel. Although this information is obtained from reliable sources, ECRI Institute cannot guarantee its accuracy.)

This Product Comparison covers low-volume, surgical, thoracic, and tracheal suction regulators that dynamically control the selected vacuum level, responding to changes in flow conditions that may be introduced during suctioning procedures. Adapters that convert continuous regulators to intermittent regulators are also covered. Other regulators, such as those controlled with a bleeder valve that does not dynamically control vacuum levels, are omitted. In addition, any accessories associated with suction regulators are excluded; however, compatible inlet and outlet fittings are listed in the chart.

Michael J. Scala, RN, BSN, EMT-P

Clinical White Paper Published in 2011 

Suction collection canisters are used in almost every patient care area. They form a reservoir where solid and liquid components are separated from air and aerosols. Once these collection vessels have been employed clinically, they become an environmental reservoir of pathogens in that patient care area. Ventilator-Associated Pneumonia (VAP) bundles commonly include the recommendation that collection canisters be changed at a minimum of Q24hrs. This literature review will attempt to demonstrate an evidence-based canister change protocol supportive of the reduction of this potential HAI vector. This evidence-based protocol recommendation could represent over $1000 worth of savings per ICU bed per year.

Bradley Thompson, MS, CCP, Appleton Medical Center – Appleton, WI

Presented at CREF 2013 – 33rd Annual Cardiothoracic Surgery Symposium

Purpose: To quantitatively evaluate a convenient, commercially available waste anesthetic gas removal system for membrane oxygenation that does not impart excessive suction across the membrane oxygenator or allow for the accumulation of positive pressure in the system. Results: Subsequent badge test resulting in the perfusion work area indicated <0.42ppm residual anesthetic with the scavenger setup in place and operational.

Keith S. Kaye, MD, MPH; Dror Marchaim, MD; Chester Smialowicz, MD; Lauren Bentley, MSBME

Infection Control and Hospital Epidemiology 2010, 31(7), 772-774.

The role of suction regulators in nosocomial infections has, to our knowledge, not been studied. A sampling of devices used in hospitals was conducted. Many regulators (173 [37%] of 470) were found to be colonized. A suction circuit model revealed that pathogens can disseminate throughout the circuit (retrograde and antegrade), colonizing an experimental patient’s stomach.

John J. Hill, BA, RRT-NPS, Director Respiratory Care Services; Michael J. Neary, MD, Director MICU/SICU, Associate Medical Director Respiratory Care Services; Caroline Panichello, CRT/RPFT, Respiratory Care Staff; Deborah Heart and Lung Center, Browns Mills, NJ, USA

Presented at the 55th Annual International Respiratory Conference (AARC 2009).

This study demonstrated that manufacturer-recommended backflushing does not adequately disinfect internal suction regulator passages. The novel approach to device sterilization offered by the Boehringer Regulator, wherein traditional, well-accepted autoclave techniques are employed to optimize device disinfection, would appear to offer a substantial clinical advantage in the prevention of nosocomial infections.