Good morning you lovely people!

We're planning to replace the suction unit on our retrieval trolley. Would anyone with personal experience care to recommend or warn me about any of the ones available?

Many thanks, Moira

(It must be spring - I came in on the motorbike this morning! )

We have galloooons of Laerdal LSU. No problems whatsoever.

The “good old” ones I hope, Snowler, not the ones that look as though they were made by Fisher Price!

The latter I'm afraid. Rock solid though.

Does anybody have any problems with the "battery save mode"?

No, I haven't just made that up!!

Anyone tried the SAM 420LX? It looks OK, compact and cheap; but I wonder if it's robust enough? Last time we moved away from Laerdal we found ourselves with a device that the nurse had to hold together with one hand whilst suctioning the child with t'other!

The Medela "Clario" may be a little too small for your needs but take a look.

It's an ingeneous design which has the pump entirely seperate from all patient tubing, collection jar etc, so the pump physically can't be flooded (our main bugbear with suction devices).

It's one of those really neat ideas that when you see it you wonder why no one thought of it before and it seems to work reliably.

Marc

Have you looked at the S-cort from Vacsax. One of the benefits is that it will take a liner system and the charger is integral, not a seperate box to get lost.

It is manufactured by SSCOR.inc http://www.sscor.com/pages04/moreduet.htm

Seem to be liked here for units that get used infrequently and left on charge most of the time.

Brian

I telephoned Laerdal for some parts for the "good old ones" Geoff mentions. Evidently parts will cease to be available at some point later this year.

I'd have to disagree with Geoff on this one - it's been a long time since I serviced one of those "good ones" (I assume the previous model of LSU in a carry-case) but I remember that the solder joints around the rotary switches and charger DIN socket regularly suffered with dry-joints (due to repeated disconnection of charger and switching on/off in service), charging indicator bulbs failed frequently (preventing proper charging), the stand-alone chargers usually went missing or ended up with the cases smashed and transformer O/C, all the soft plastics around the vacuum chamber tended to disintegrate over time plus vacuum seals and one-way valves were a bit of a pain to replace. The batteries were also Ni-Cd so they suffered with voltage-depression (oxidised plates, hence high-resistance internally, causing series volt-drops) and memory-effect (effective loss of capacity). Functional verification was also a bit messy - water and a stopwatch was required to test flow rates.

The newer model LSU is certainly easier for users to quickly check function, Technicians to verify performance and for either to change batteries as and when required (assuming operators also do the required checks). On balance I think the newer models are more reliable but when they fail they're likely to be more expensive to repair unless it's simply problem related to a faulty battery. The newer models are mechanically more robust, in my opinion, and have preset vacuum adjustments (the older models of LSU required an optional, external, regulator valve/gauge). The inclusion of an in-line filter should prevent expensive replacement of the internal components (otherwise they will eventually seize-up after a period of being contaminated with "aerosol" from aspirated fluids in the suction container). Use of disposable liners is preferable and cost-effective since they usually have a filter incorporated to protect the suction device - if there is internal contamination then replacement of the mechanism means the device is a write-off.

Yes, yes, Richard. But you could fix the things with bits form the souk! And wasn’t that a windscreen-wiper motor or something?

Landrover wiper motor - if I remember correctly
Hydraulic motor solenoid in the bottom of an Eshmann table is a Lucas lorry starter solenoid. They had not even bothered to take it out the box when we ordered an "official" spare part.
Robert

Hey Graham, that sounds like a business opportunity, Man! I know that many biomed departments still have boxes of old LSU bits lying around. Maybe we should buy them all up! We could keep these classics going for ever, or bung them on eBay . Anybody want to have a go?

Here we go! Better check out this one ! Looks like a few bits may still be available .

Meanwhile, here is a new one waiting for the bus!

Nice one, Robert! Any more like that? Anyone ... ?

In the appropriate thread, of course.

Anyone thought of trying injector suction? Some good units out there.

Good for a laugh when the staff insist they can hear them leaking (whilst operating)

Thanks for those excellent suggestions, I'm following them up.

Moira

Mr Ling has no need to use water and a stopwatch to test the flow rate of any suction machine! In Lincoln we use a gas flow meter set to measure air flow to check the suction flow. The old style Laerdal suction unit is expected to be able to produce 10 litres / min on half setting and 20 litres / min on full setting. The new style one is expected to produce > 25 litres / min at maximum setting.

Unfortunately, at the time, Mr Ling did. I think the volume of water aspirated in n-seconds was used to give us a clue to performance (actually this was recommended by the manufacturer). Measuring water volume and time is easy (without a flow meter) but it can be a bit messy. Otherwise it's a bit subjective trying to guess performance of anything that "sucks or blows". We use the newer LSU and have fancy flow meter(s) where I work nowadays. The older LSUs are just too unreliable in my experience; irrespective of how much suck they have on a good day and how accurately it can be measured.

Two comments there:- Yes, Richard, I reckon it’s always best to use test regimes that can be easily reproduced and carried out in the field, as it were.

Secondly, I have noticed a tendency for late models of suction units to produce what I would consider as “violent” levels of vacuum. How much “suck” do you actually need, I wonder (especially with neonates and young children)?

A few things to consider it that respect Geoff - 1) the operator is on hand to ensure that the suction unit vacuum is not damaging to the patient, 2) newer units such as the LSU regulate vacuum to a preset level, using a vacuum regulator, which can be preset by the operator and, 3) most suction units indicate the vacuum in the suction tubing/container on a gauge. There's also the consideration that the risk of potential damage due to excessive vacuum is possibly outweighed by the benefits of suctioning (considering emergency situations in particular).

In practice Yankauer suction-catheter handpieces are available with a finger-controlled leak, bypassing the path of the aspirate with air, to allow fine control of the vacuum applied. This effectively limits peak applied vacuum (given a particular suction displacement, resistance to flow of aspirate/air in the suction tubing/filter, viscosity of aspirate and peak vacuum attainable) to somewhat less than the peak vacuum that can be attained at the vacuum source or that vacuum preset by the regulator.

Only under no-flow conditions, without a vacuum regulator fitted, or a vacuuum regulator that is preset by the operator to the maximum setting, possibly inappropriately, should the peak vacuum attainable by any suction unit be applied to the patient, in theory. This assumes that the blockage/restriction, leading to excessive vacuum applied to the patient, is at the suction-catheter tip itself, i.e. is in contact with patient tissue, since any blockage within the suction unit/tubing will result in zero or much reduced suction at the suction-catheter tip.

To be effective suction units need to have more than adequate vacuum and displacement (flow rates) to overcome the resistance in the suction tubing/filter/vacuum source, the viscosity of aspirate and, initially, remove the volume of air in the collection bottle as fast as possible, to enable removal of aspirate from the patient quickly. Manufacturers provide the features to allow this to be done safely but it's up to the operator to be responsible and to make sure they're using these appropriately in my opinion.