Laerdal suction machine

⚠ Important safety information

Only those signed off as competent by a professional can carry out suction. Please contact the team if you need training.

Suction must only be done on children and young people who have their own suction machine and have a care plan for suction written by a healthcare professional.

What is suction and how does it work?

Suction uses vacuum pressure to remove fluid from someone’s airway. This is done to keep the airway clear from fluid (saliva, mucus and sick), if someone struggles to do this for themselves.

Suction can also be used to collect a sputum sample, which is a thick and sticky type of mucus that is made in the lungs.

There should be no pain or discomfort while using suction. The procedure is low risk can make a considerable difference to a person’s quality of life.

Types of suction

You should only do the specific type of suction which is in your child’s care plan and which you are competent to perform. The care plan written for your child will include a maximum depth for suction which must be adhered to.

Nasal suction

Nasal suction uses a soft, flexible catheter passed to a short length into the nasal cavity.

Nasopharyngeal suction

Nasopharyngeal suction uses a soft, flexible catheter into the nostril and inserted towards the back of the mouth (the pharynx).

To measure the depth of nasopharyngeal suction, have your child facing forward, and measure from the nostril to the mid part of the ear lobe. If you feel like the fluids are not being removed properly, you can go slightly deeper in 1cm increments to a maximum of 3cm.

Oral suction

Oral suction uses a hard plastic ‘yankaeur’ catheter in the mouth and goes no further than the back of the teeth.

Oropharyngeal suction

Oropharyngeal suction uses a soft, flexible catheter along the roof of the mouth and down the throat.

To measure the depth of oropharyngeal suction, measure from your child’s lips to their, ear or deeper to the bottom of their neck (sternal notch) if needed.

Oropharyngeal suction should be assessed by a respiratory consultant or physiotherapist and must be risk assessed on a child’s individual needs.

Signs that your child needs suction

Signs that your child needs suction includes:

• change in your child’s voice or audible sounds
• coughing or attempting to cough
• swallowing more than usual, chewing movements or lip smacking
• visible fluids
• been sick
• increased effort to breathe (faster or more shallow breathing)
• change in your child’s colour and appearance (pale, looking blue, sweaty)
• panicked expression
• child may ask for suction

Possible side effects

Hypoxia

Doing suction for too long can cause low oxygen levels. Do not use suction for longer than 15 seconds at a time. If more suction is needed give your child an opportunity to take a few breaths and then start the suction again.

Discomfort and  pain

If your child is able to clear their own fluids, please encourage this. However, suction is sometimes the better option for your child’s comfort and to make sure their airway is cleared safely. Be gentle and careful when using suction as your child may find it unpleasant.

Infection

If suction is done with unclean equipment or without proper infection control techniques, it can cause an infection. Always wash your hands and keep equipment clean by washing frequently and changing tubing and catheters as per guidelines.

Trauma to mouth or nose

Poor technique, overuse or incorrect equipment (catheter size) can cause trauma to the area suctioned. Please make sure you are using the correct size catheter for the suction needed and that you do not use suction repeatedly or unnecessarily. If trauma is caused due to overuse please discuss with a healthcare professional, as further treatment may need to be considered.

Being sick

Some people may gag when the catheter is inserted. Always stop feeding when suctioning to stop your child from being sick.

Overuse

Unnecessary or frequent suction can lead to an increase in fluids by stimulating the glands. Only use suction if required to clear the airway.

Common concerns

Thick or green fluid can be an indication that there is infection or your child is unwell. Please contact your GP or your child’s Care Team to discuss these symptoms and appropriate treatment.

Blood-stained fluid could indicate trauma has been caused. A small amount of blood should be of little concern, however considerable amounts of blood should be reported to a healthcare professional.

If the type or depth of suction is not as effective anymore, then your child may need a review to change to increase the depth, change route or change catheter type.

There should not be any pain or discomfort, but if you feel your child is in pain when suction is given, please discuss with relevant professionals.

If your child has a care plan, a competent person needs to be with them at all times during school or being away from home. Training can be given to carers, family members and school staff as needed. The suction machine should always be available for use, and must always be charged and with your child.

Directions for use and equipment

Monitor your child throughout, be mindful of infection control and report any concerns you may have.

If the child is not breathing, you must immediately stop and begin with basic life support, or CPR.

Oral suction

1. Turn on the suction unit to 120 to 150mmHG
2. Using the appropriate catheter (usually a yankaeur), insert the catheter into your child’s mouth
3. Apply pressure by covering the hole on the catheter
4. Pull out the catheter gently and slowly
5. You can also use this catheter in the cheek pockets and under the tongue. Do not insert the catheter beyond the back of the teeth
6. Rinse the tubing by suctioning clean water in a bottle
7. Turn off the suction unit

Do not use suction in the mouth for longer than 10 seconds at a time. If more suction is needed, let your child rest for around 20 to 30 seconds before starting again.

Nasal suction

1. Turn on the suction unit to 120 to 150mmHG
2. Insert the flexi catheter into the entrance of the nostril plus a couple of centimetres
3. Apply pressure by covering the hole on the catheter
4. Pull out the catheter gently and slowly
5. Do the same to the opposite nostril if needed
6. Turn off the suction unit and dispose of the single use catheter

Nasopharyngeal suction

1. Turn on the suction unit to 120 to 150mmHG
2. Using an appropriately sized catheter, place your fingers at the prescribed depth on the catheter
3. Insert the catheter into the nostril until your fingers on the catheter meet the entrance to the nostril

Remember the nasal cavity does not go straight up, so you need to use an up and over motion to follow the direction of the nose. If you feel , gently pull it out and try again.

4. Apply pressure by covering the hole on the catheter
5. Pull out the catheter gently and slowly
6. Do the same to the opposite nostril if needed
7. Turn off the suction unit and dispose of the single use catheter

Do not use suction for longer than 15 seconds at a time. If more suction is needed, let your child rest for around 20 to 30 seconds before starting again.

Oropharyngeal suction

Oropharyngeal suction should be assessed by a respiratory consultant or physiotherapist and must be risk assessed on a child’s individual needs. Do not use this method if this does not apply to your child.

1. Turn on the suction unit to 120 to 150mmHG
2. Using an appropriately sized catheter, place your fingers at the prescribed depth on the catheter
3. Insert the catheter into the mouth and towards the throat until your fingers on the catheter meet the lips
4. Apply pressure by covering the hole on the catheter
5. Pull out the catheter gently and slowly
6. You can also use this catheter in the cheek pockets and under the tongue
7. Turn off the suction unit and dispose of the single use catheter

Do not use suction for longer than 15 seconds at a time. If more suction is needed, let your child rest for around 20 to 30 seconds before starting again.

Equipment

Laerdal suction unit

The laerdal suction unit comes with disposable bag which catches the secretions. The bag should be changed when 3 quarters full, or if it has not been used in a long time but still has fluid inside.

The tubing which attaches to catheter should be changed weekly or monthly dependant on use.

The unit should be serviced appropriately and kept on charge when not in use.

Yankaeur suction catheter

The yankaeur suction catheter should be used for oral suction only. The catheter should be inserted through after each use. Attach a new one to the suction machine every week your child needs suction frequently.

Flexible Catheter

The flexible catheter should be used for nasal, nasopharyngeal and oropharyngeal suction, and is single use. It comes in many different sizes, size will be determined by healthcare professional.

Please order equipment by emailing Helena.parentcarer@nhs.net and always make sure you have a 2-week supply in stock.

Suction machines need to be serviced every year by Mediquip. The date this is needed and the contact number for Mediquip are on the machine. Please contact Mediquip to arrange a service when needed.

How to set up, clean and store a laerdal suction machine

Test the unit is working. Always remove catheter to do a test.

1. Hold test button
2. Turn dial to 500
3. When the first light shows cover suction tubing end
4. Wait until the 4 test lights have shown
5. Turn machine back to 0

Store the unit upright to avoid secretions spilling into unit.

Watch how to set up the machine here.

⚠ If you have any concerns about your child or young persons condition relating to their suction requirements, please contact the team.

If you have immediate concerns and feel your child needs medical attention, please attend your GP or Accident and Emergency.