We have been contacted by Siemens to advise us that we should no longer use closed circuit suction catheters with their Servo300 and 900 ventilators. Closed circuit suction has been standard practice for some time and we feel somewhat uneasy about the request for 950 for each ventilator to upgrade the pressure transducers. I wonder if anyone else has similar thoughts about paying for what appears to be a design problem? I am particularly interested to know what other hospitals have done in respect of changing back to open suction, or placing limitations on use of either ventilator or suction devices.
I reallise its of no use to you at this point, but weve started to add clauses to tenders including things like "can be used with jet vents, closed circuit suction, certain humidifiers etc."
Russ: We also received the information from Siemens. This resulted in lengthy 'talks' with the users who, as could be imagined were none too keen in stopping closed loop practises. In the end we decided to accept the hit and have requested mod kits for our ventilators (total cost £5000 ) Are we in the wrong job?
Thought; if a Servo transducer is damaged (for whatever reason..), and the vent is under contract - are Siemens obliged to replace it? And would the replacement be of the old or modified type?
Surely if the company can prove you where operating the device against their suggested methods you would be responsible for the damage. Also what about (more importantly) if the patient on the device was injured and it was proven that you didnt carry out the suppliers suggested upgrade, which is why the patient was injured.
We have of course thought long and hard about this business and as a team agreed to minimise the risks in the following way. We know that the ventilators will have to be modified - our problem is with who will or should pay for them. Meanwhile; It has been suggested that the risk of injury and damage is greatest when used with volume modes. We rarely use these modes. Patients who require closed circuits for clinical need may be harmed more by the removal of the closed circuit than the theoretical risk from the ventilator. Our intensivists feel that until the modifications are made, that this is a matter of balancing risks. We will use closed circuits where the clinical indications are the greatest and avoid them when using volume modes, or where another type of suctioning is possible without increasing the risk to patients or staff. I understand that neighbouring hospitals are adopting a similar approach. We continue to discuss who will pay for the necessary upgrades to the ventilators. Thanks to everyone who has contributed thoughts on this.
I doesn't mean you can't use close circuit suction. It indicates that if its done wrong then their is a very remote chance the transducers may suffer. The upgrade is not a fix, its only a more robust transducer.
Its up to the nurses to get it right and make sure their policy for carrying out this procedure is fool proof. On this basis, nursing will foot the bill for the upgrade to my four 300's and we (cos we're so obliging!) will carry it out.
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