Tue, 20 May 2008|
Fire Engineering EMS Techincal Editor Mike McEvoy discusses the best ways to clear a patient's airway and some of the pitfalls of suction.
Today -- like to talk about suction. What's the best advice to use -- a pre hospital environment to clear patient's airway and where some of the pitfalls of suction. In you're in -- training probably learned that there's a maximum up time that you consumption patient for. Some -- -- have been taught to hold our breath while we suction patient not a very bright idea as you probably become -- profit as your patient becomes toxic. So what is the maximum amount of time that you should suction patient for. The answer to that question is -- suction for as long as is necessary to clear patient's airway. If a person regard it takes 430 seconds 3540 seconds it's necessary to suction until the patient's airway is clear. -- the airway becomes clear that when you stop -- I want to talk a little bit about what are the best devices to use. Prior to that though the question is what are we actually trying to accomplish or -- -- inherently. Clearly secretions can be a problem for patients who regurgitate -- vomit and greenhouse environment especially one patient. Not able to clear those secretions on there way. But -- it actually fluid that we're trying to remove or is chunks of objects -- -- The answer to that question is it's large particles that were trying to remove from the way. Recent studies have -- that individuals like you and during sleep to determine. Whether or not we actually ask -- Stomach contents into -- -- on a nightly basis. And found that in all of us actually pass rates small portions. Of fluid that comes up remarks coming in regard to compassion during actually. That does not cause pneumonia. None of us wake up in the morning with pneumonia from having -- rated fluid. Therefore a patient who were attempting to suction you know -- gets pneumonia. Or becomes -- when large objects or chunks of things get into there -- That's what you're attempting to clear when -- suction. That then leads us to conclude that the devices that we should be using the suction -- patient. Should be large board devices. You may not seeing. A smaller suction catheter. And you may actually carry small suction captors such as this fourteenth French suction catheter that comes in -- kit with some glove. And it's a soft flexible catheter. Not a device that you wanna use the clear chunks out of a patient's airway. Soft flexible suction catheters are for sanctioning tracheotomy. Functioning and -- curriculum to. And perhaps nasal particularly -- -- patient where conscious person is unable to clear fluid on there. Airway and you need to pass the catheter through this note. Not the type of -- -- that you use on a basis for unconscious patient or someone was Airways have opted. Like chunks of bomb tests were -- education. Know most cases. You wanna use a device similar to what comes with most suction -- large -- -- As large -- as is possible. He attached to that a rigid. Suction device such as this yank our suction handle. And notice that the handle on this ambulance was kept wrapped up until it's needed for use. In order to keep that from being contaminated by things that are on the surface of the ambulance. Will attach the yank our suction -- to it and turned the suction device son. Many commercial units have a vacuum -- regulator you can dial on the device how many millimeters a vacuum. You wish the machine. To pull out of the patient. Next question is how much should -- use on an adult patient. -- Airways included. With secretions -- -- chunks of bomb -- us you wanna use more than 200 millimeters of Mercury in north of that in there way out. This device would be turned to some setting higher than 200 -- news America. On a pediatric patient that setting should be. Less than 120. Millimeters and there. Out of you -- the enough flow that you need to actually clear a patient there. The length of time as I mentioned before that necessary. The suction LA is as long as it takes to clear the secretions. Cooling -- Other important things to remember about suction on our patient position. Obviously people who had difficulty controlling owner -- new best side line position when that's not Contra indicated -- spinal injury. And people who are having difficulty controlling their -- oftentimes need an oral airway or nasal -- insert. People who of course auctioning off and candidate -- an airway devices well. The other thing you want to keep in mind is that any suction thing you're doing a patient has the potential to expose you to -- substances. And using gloves and probably weren't eye protection and they -- is imperative. When trying to clear away with large war suction -- -- Mike Mac -- thanks for watching.