Operating a suction machine demands skill and precision. Yet many nurses only perform suctioning at times of high stress and chaos, such as in a tactical medical scenario or on a patient who has aspirated. Suction errors are preventable, but can also be catastrophic. According to research published in 2016, medical error is the third leading cause of death in the United States.
1. Not Having Equipment Ready
No matter how good the equipment is, if it’s not ready to go at critical junctures, it can leave your patients in danger. A 2018 case report details a suction error. In that case, the suction equipment was properly tested and worked well. Because the equipment had been improperly set up, however, the equipment failed.
To reduce the risk of similar issues:
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Regularly test equipment and power it on before each shift.
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Store disposables and other key equipment in an accessible location along with equipment.
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Dispose of catheters and other items that no longer work or are damaged.
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Ensure equipment is properly set up and assembled before each use.
2. Suctioning for Too Long
AARC guidelines indicate that the upper limit for suctioning time is 15 seconds. Suctioning in excess of this time frame greatly increases the risk of injuries such as hypoxia. Ensure you don’t over-suction by suctioning only while withdrawing the suction catheter, and never during insertion.
3. Using the Wrong Size Catheter
There is no one-size-fits-all catheter. The smaller airways of children and neonates demand smaller catheters. Geriatrics and those with fragile airways may also need smaller catheters, or more flexible ones. In general, the suction catheter should have an external diameter of no more than 50 percent of the endotracheal tube’s internal diameter.
4. Routine Suctioning
Suctioning is not a routine or prophylactic medical procedure. Suction the patient only when there are clear indications for suctioning. Those include:
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Increased pulse
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Noisy respiratory sounds
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Visible secretions
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Non-productive cough
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Inability to clear the airway on one’s own
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Shortness of breath
5. Suctioning Patients with Contraindications for Suctioning
Suctioning is not safe for all patients. Patients with recent head and neck injuries, including those with suspected spinal cord injuries, should not be suctioned unless the benefits of doing so clearly outweigh the risks.
6. Improper Sterilization and Decontamination
Patients with fragile immune systems and communicable diseases are more likely to need suctioning. This highlights the need for proper sterilization and decontamination. The right procedure depends on the equipment you use. Follow the manufacturer’s recommendations each and every time. To decrease the spread of communicable diseases:
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Wash your hands before and after sterilization.
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Wear protective equipment while cleaning the suction machine.
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Never reuse single-use devices.
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Ensure the equipment has time to fully dry before putting it in an enclosed storage area.
7. Using the Wrong Suction Machine
A number of online articles and manufacturer guides claim that one type of suctioning is superior to another. Yet a 2017 study disputes this notion. When comparing rates of ventilator-associated pneumonia and mortality, researchers found no significant differences between groups that used closed and open suctioning.
It’s not the type of equipment that matters, since all types of suction equipment have their place. What matters instead is the quality of the equipment. The wrong suction machine may be more difficult to clean, have weak batteries, or provide suction that weakens as you suction the patient. Quality suction machines offer clear details about their suction and vacuum power, and live up to their promises.
A suction machine that is weaker than necessary, that dies early, or that offers inconsistent suctioning puts your patients in danger. They deserve better. For help choosing the right suction machine for your patient population, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.
