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Aspirators, Emergency
Aspirators, Emergency
Aspirators, Emergency
Purpose
Portable emergency aspirators are used to remove obstructing
secretions, blood, or vomitus from a patient’s airway to keep air passages
to the lungs open and to allow spontaneous or mechanical ventilation.
Suctioning can be either oropharyngeal (to prepare for emergency
intubation or to remove secretions from the upper airway above the glottis)
or tracheal (to remove secretions and to maintain the airway of an
intubated patient).
In hospitals, battery operation is less important than it is in the field
(e.g., on ambulances). Hospitals use emergency aspirators on code carts
and in areas that do not have access to the central vacuum system.
Principles of operation
The typical components of emergency aspirators are a suction (vacuum) pump, tubing (catheters), regulators
and gauges, a collection canister, batteries and a charger, and a carrying case. These units can rest on a storeroom
shelf, on a bedside stand in the hospital, or on a shelf in the ambulance.
Vacuum pumps
The main component of an emergency aspirator is the vacuum
pump, which creates the suction necessary for aspiration. The pumps
of most emergency aspirators are diaphragm pumps, in which a UMDNS Information
mechanical drive flexes a rubber diaphragm back and forth in a
chamber, alternately increasing and decreasing the chamber volume This Product Comparison covers the following
device term and product code as listed in
and the pressure (see Figure 1). One-way valves direct compressed air ECRI Institute’s Universal Medical Device
to the exhaust outlet and allow suctioned air to enter the vacuum inlet. Nomenclature System™ (UMDNS™):
Aspirators, Emergency [15-016]
Some units, however, use rotary-vane pumps, in which sliding vanes
5200 Butler Pike, Plymouth Meeting, PA 19462-1298, USA Tel +1 (610) 825-6000 Fax +1 (610) 834-1275 Web www.ecri.org E-mail hpcs@ecri.org
Aspirators, Emergency
light. Some aspirators have indicators that light when the battery charger is connected both to the unit and to wall
power, allowing quick confirmation of proper charger connection and internal connection to the battery circuit.
Certain models are available with an optional manual pump in case battery power is lost; however, the manual
pump is practical only if an extra person is available to operate it.
Portable aspirators are usually supplied with a carrying case. The two most typical styles are hard plastic and
soft-pack cases. A portable hard plastic case can protect the pump from mechanical shocks during emergency
medical services (EMS) use; a soft case, although not as durable as a hard case, is usually lighter.
Reported problems
Errors in displayed vacuum levels result from both gauge inaccuracy and poor placement of the gauge in the
system to measure vacuum. Typically, a gauge will be most accurate if it is located at the canister. A gauge placed
near the pump can produce falsely high readings. To check the maximum vacuum level at a given regulator
setting, the user should read the gauge when the suction catheter is completely occluded.
Units without shutoff devices may allow aspirated material to flow through the pump, eventually forcing it to
stop. This could cause suctioning to be interrupted for several minutes while the canister is emptied, the pump is
cleaned, and the unit is restarted. Cleaning or overflow may also expose users to infectious material. Smaller-
capacity canisters can increase the risk of overflow and may need to be changed more often, especially in models
without adequate overflow protection.
Infection control practices require that aspirate not be released routinely into the environment. Compared to
disposable canisters, reusable canisters pose greater infection risks during handling and require many safeguards
when emptying, cleaning, and disinfecting. Operators should use universal precautions, including wearing
gloves, face shields or masks, and gowns, when performing these procedures. Hospitals are usually better staffed
and equipped for this service than EMS areas; however, even hospitals usually choose disposables. Manufacturer
instructions for disinfecting reusable equipment, as well as for disinfecting the suction pump, should be strictly
followed to prevent cross-contamination. In addition, used canisters and other disposables must be disposed of in
accordance with state and local medical waste regulations.
Larger units can be difficult to carry and remove quickly from their cases at an emergency site. Units with
limited storage space can be difficult to pack and to close without crimping the hose. A crimped hose may cause
problems during use because the vacuum inside the hose could cause it to collapse and restrict flow. Some units
include hose wraps to help alleviate this problem, but unless they are wrapped carefully, hoses can be difficult to
untangle.
Exhaust from some pumps is vented inside the case and could be partially occluded by an object pressing
against the outside of the case, possibly diminishing the performance of the aspirator.
Users should also be aware that vibrations caused by the vacuum pump may cause a portable aspirator to
move or “walk” during use when placed on a flat, smooth surface.
Battery-powered devices will often be less dependable than suction regulators used with a hospital’s more
reliable central vacuum system. Therefore, battery-powered aspirators should not be installed on hospital crash
carts unless they are serving areas where the central vacuum system is inaccessible or unreliable. ECRI Institute
recommends that at minimum, one crash cart in the hospital (typically in the emergency room) be equipped with
a portable emergency aspirator and be used to cover public areas of the hospital that are not served by the central
vacuum system.
Purchase considerations
ECRI Institute recommendations
Included in the accompanying comparison chart are ECRI Institute’s recommendations for minimum
performance requirements for emergency aspirators. Purchasers must first determine the intended applications of
the aspirator; some units are designed only for oropharyngeal use, while others can also be used for tracheal
aspiration.
Emergency aspiration may require moderate to high vacuum and flow rates. Units should be able to provide
suction of ≥400 mm Hg at maximum settings to remove tenacious secretions but should also allow lower vacuum
levels to help prevent tissue damage. Also, the aspirator should be capable of reaching a vacuum level of 300 mm
Hg in ≤4 seconds. Vacuum gauges and vacuum-limiting devices (e.g., regulators) are helpful in allowing
application of appropriate and safe suction levels. Vacuum gauges should be both accurate and easy to read.
Collection canisters—whether disposable or reusable—should hold ≥1,000 mL of liquid and should prevent
overflow of aspirated material, which may clog the aspirator and should be considered infectious.
Since emergency aspirators are commonly used outside the hospital setting, they should be easy to use and
transport. Units should weigh <6 kg (including the carrying case and all accessories), although models intended
solely for crash-cart use can weigh more. Fully charged batteries should power the unit at maximum vacuum for
≥30 minutes, and both audible and visual warnings should alert the user when batteries are nearing depletion.
Integral battery chargers are preferable to separate units to prevent loss of the charger.
Other considerations
Case designs preclude some emergency aspirators from crash-cart use, especially if the case is an integral part
of the unit. Some units are relatively heavy and less convenient to carry, which is a consideration if the aspirator
is to be used by emergency medical technicians (EMTs).
Vacuum regulators or gauges are optional on most units. If the unit is to be used for oropharyngeal suctioning
only, purchasing models without these options will reduce costs and simplify operation. However, if a vacuum
gauge is included, users should install it properly, in a manner that does not cause falsely low readings that result
in higher-than-intended vacuum levels. For proper measurement of vacuum levels, the end of the tubing must be
occluded.
Most units with disposable canisters can accept at least some alternative manufacturers’ canisters. Standard
canisters may be more convenient to order, and they offer the user a choice of suppliers. However, installed filters
supplied with the canisters will differ; some may severely limit airflow rates. The cost of disposables should be
weighed against the cost, time, and infection risks associated with the disinfection of reusables.
The aspirator should be easy and intuitive to turn on, adjust, and operate. A quick and simple method of
setting the unit to maximum vacuum for oropharyngeal suctioning is desirable. It should be uncomplicated to
empty or exchange canisters and continue to operate the pump without significant risk of instrument or operator
contamination. Disposing of the canister and its contents should be easy, with minimal risk of spills or
contamination.
Disconnecting and reconnecting the unit at the recharging station should be convenient; the connection should
be secure, even if performed in a hurry. An indicator should show whether the charger is connected to a power
source and to the battery. An indicator of when the battery is ready (fully or mostly charged) is desirable, as is a
means to continue operation (e.g., by exchanging batteries) in the event of a low or failed battery during use.
As with any device to be used for resuscitation, emergency aspirators should undergo acceptance testing to
ensure that they meet maximum vacuum and flow specifications. Units being considered for use aboard transport
helicopters should be assessed more rigorously to ensure that there is no electromagnetic interference with
instrumentation or the telecommunication systems.
Cost containment
Because emergency aspirators entail ongoing operational costs, the initial acquisition cost does not accurately
reflect the total cost of ownership. Therefore, a purchase decision should be based on issues such as life-cycle cost
(LCC), discount rates and non-price-related benefits offered by the supplier, and standardization with existing
equipment in the department or hospital (i.e., purchasing all emergency aspirators and/or collection containers
from one supplier).
An LCC analysis can be used to compare high-cost alternatives and/or to determine the positive or negative
economic value of a single alternative. Because it examines the cash-flow impact of initial acquisition costs and
operating costs over a period of time, LCC analysis is most useful for comparing alternatives with different cash
flows and for revealing the total costs of equipment ownership. One LCC technique—present value (PV)
analysis—is especially useful because it accounts for inflation and for the time value of money (i.e., money
received today is worth more than money received at a later date). Conducting a PV/LCC analysis often
demonstrates that the cost of ownership includes more than just the initial acquisition cost and that a small
increase in initial acquisition cost may produce significant savings in long-term operating costs. The PV is
calculated using the annual cash outflow, the dollar discount factor (the cost of capital), and the lifetime of the
equipment (in years) in a mathematical equation.
The following represents a sample seven-year PV/LCC analysis for an emergency aspirator.
Operating Costs
Disposable collection containers = $3,000/year
Disposable PVC tubing = $2,500/year
Disposable Yankauer catheters = $2,000/year
Total Operating Costs = $7,500/year
PV = ($51,138)
Other costs not included in the above analysis that should be considered for budgetary planning include other
disposables, accessories such as bacterial filters, optional accessories, and inspection and repair costs.
As illustrated by the above sample PV/LCC analysis, the initial acquisition cost is only a fraction of the total
cost of operation over seven years. Therefore, rather than making a purchase decision based solely on the
acquisition cost of an emergency aspirator, buyers should consider operating costs over the lifetime of the
equipment.
Prices for disposable tubing and catheters vary greatly, depending on a number of factors, including type, size,
material, manufacturer, and bulk-rate discounts. Many of these disposables can be used with a number of
manufacturers’ emergency aspirators.
For further information on PV/LCC analysis, customized analyses, and purchase decision support, readers
should contact ECRI Institute’s SELECTplus™ Group.
Stage of development
Portable emergency aspirators are a mature and stable technology, and revolutionary changes or
improvements are not expected. Manufacturers will most likely continue to develop better and lighter-weight,
higher-capacity canisters and longer-lasting batteries.
Bibliography
Cummins RO, ed. Textbook of advanced cardiac life support. Dallas: American Heart Association; 2001.
Dahlgren BE, Hogberg R, Nilsson HG. Portable, but suitable: devices in prehospital care might be hazardous to
patient or to aviation safety. Prehospital Disaster Med 1997 Jan-Mar;12(1):64-7.
Dahlgren BE, Nilsson H, Bjorn P, et al. Appropriate suction device in rescue medicine. Ann Emerg Med 1987
Dec;16(12):1362-4.
Dick T. Suction devices: a guide to emergency field aspirators. JEMS 1985 Mar;10(3):30-41, 44-6.
ECRI Institute. [Tracheal and surgical aspirators]. BiomedicalBenchmark. Procedure no. 433.
Portable emergency aspirators [evaluation]. Health Devices 1991 Feb;20(2):55-72.
Portable emergency aspirators [evaluation update]. Health Devices 1991 Dec;20(12):457-8.
Hatlestad D. Clearing the airway. Emerg Med Serv 2004 Jan;33(1):55-64.
McSweeney C, Giblin M, Davis A, et al. Pneumatic and oxygen delivery testing standards: a guide to testing suction
units, and oxygen delivery systems. 4th ed. Trenton: New Jersey Department of Health and Senior Services; 2003.
Also available: http://www.state.nj.us/health/ems/.
Rossi R, Jäger G, Ahnefeld FW, et al. Efficiency of suction pumps for the emergency medicine setting. Arch Emerg
Med 1992 Mar;9(1):44-50.
Supplier information
ALLIED
Allied Healthcare Products Inc [105171]
1720 Sublette Ave
St Louis, MO 63110
Phone: (314) 771-2400, (800) 444-3954 Fax: (314) 771-4616, (800) 477-7701
Internet: http://www.alliedhpi.com
E-mail: customerservice@alliedhpi.com
ATMOS
ATMOS Medica SL [439522]
Calle Torrent d'en Pregaria 27
Mataro (Barcelona) E-08304
Spain
Phone: 34 (90) 2193580 Fax: 34 (93) 7573283
Internet: http://www.atmosmed.es
E-mail: atmos@atmosmed.de
EMAGIN
Blue Cross Emergency Co Ltd [163241]
3-12-9 Hongo Bunkyo-ku
Tokyo 131-0033
Japan
Phone: 81 (3) 38152220 Fax: 81 (3) 38152229
Internet: http://www.bluecross-e.co.jp/index-e.html
E-mail: bluecross-e@bluecross-e.co.jp
ERIE MEDICAL
Erie Medical Div Ocenco Inc [103753]
Lakeview Corporate Park 10225 82nd Ave
Pleasant Prairie, WI 53158-5801
Phone: (262) 947-9000, (800) 932-2293 Fax: (262) 947-9020
Internet: http://www.eriemedical.com
E-mail: sales@eriemedical.com
GABLER MEDICAL
Gabler Medical (UK) Ltd [192820]
Warden House 37 Manor Road
Colchester CO3 3LX
England
Phone: 44 (1206) 576864 Fax: 44 (1206) 768680
Internet: http://www.gablermedical.com
E-mail: wsales@gablermedical.com
GIMA
GIMA SpA [345887]
via Monza 102
Gessate (MI) I-20060
Italy
Phone: 39 (02) 953854209 Fax: 39 (02) 95380056
Internet: http://www.gimaitaly.com
E-mail: gima@gimaitaly.com
IMPACT
Impact Instrumentation Inc [101885]
27 Fairfield Pl PO Box 508
West Caldwell, NJ 07006-0508
Phone: (973) 882-1212, (800) 969-0750 Fax: (973) 882-4993
Internet: http://www.impactii.com
E-mail: info@impactinstrumentation.com
LAERDAL
Laerdal Medical Corp [101417]
167 Myers Corners Rd PO Box 1840
Wappingers Falls, NY 12590-8840
Phone: (845) 297-7770, (877) 523-7325 Fax: (845) 297-1137, (800) 227-1143
Internet: http://www.laerdal.com
E-mail: customerservice@laerdal.com
MEDELA
Medela Espana [451801]
Calle Manual Fernandez Marquez 49
Badalona E-08918
Spain
Phone: 34 (93) 3205969 Fax: 34 (93) 3205531
Internet: http://www.medela.es
E-mail: info@medela.es
Medela AG [156407]
Laettichstrasse 4b
Baar CH-6341
Switzerland
Phone: 41 (41) 7695151 Fax: 41 (41) 7695111
Internet: http://www.medela.com
E-mail: info@medela.ch
MGE WORLDWIDE
MG Electric (Colchester) Ltd [151092]
Wyncolls Road
Colchester CO4 9HX
England
Phone: 44 (1206) 842244 Fax: 44 (1206) 845849
Internet: http://www.mgeworldwide.com
E-mail: sales@mgelectric.co.uk
OHIO MEDICAL
Squire-Cogswell/Aeros Instruments Inc [392253]
1111 Lakeside Dr
Gurnee, IL 60031
Phone: (847) 855-0500, (800) 448-0770 Fax: (847) 855-6300
Internet: http://www.squire-cogswell.com
E-mail: info@squire-cogswell.com
OXYLITRE
Oxylitre Ltd [187944]
Morton House Skerton Road Old Trafford
Manchester M16 0WJ
England
Phone: 44 (161) 8726322 Fax: 44 (161) 8487914
Internet: http://www.oxylitre.co.uk
E-mail: sales@oxylitre.co.uk
SOEHNGEN
W Soehngen GmbH [286563]
Postfach 1554
Taunusstein D-65223
Germany
Phone: 49 (6128) 87321 Fax: 49 (6128) 87330
Internet: http://www.soehngen.com
E-mail: info@soehngen.com
SSCOR
SSCOR Inc [104072]
11064 Randall St
Sun Valley, CA 91352-2621
Phone: (818) 504-4054, (800) 434-5211 Fax: (818) 504-6032
Internet: http://www.sscor.com
E-mail: marketing@sscor.com
WEINMANN
Weinmann Geraete fur Medizin GmbH & Co KG [282612]
Kronsaalsweg 40
Hamburg D-22525
Germany
Phone: 49 (40) 547020 Fax: 49 (40) 54702461
Internet: http://www.weinmann.de
E-mail: info@weinmann.de
Note: The data in the charts derive from suppliers’ specifications and have not been verified through
independent testing by ECRI Institute or any other agency. Because test methods vary, different products’
specifications are not always comparable. Moreover, products and specifications are subject to frequent changes.
ECRI Institute is not responsible for the quality or validity of the information presented or for any adverse
consequences of acting on such information.
When reading the charts, keep in mind that, unless otherwise noted, the list price does not reflect supplier
discounts. And although we try to indicate which features and characteristics are standard and which are not,
some may be optional, at additional cost.
For those models whose prices were supplied to us in currencies other than U.S. dollars, we have also listed the
conversion to U.S. dollars to facilitate comparison among models. However, keep in mind that exchange rates change
often.
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