The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

THE EFFICACY OF BACKFLUSHING SUCTION REGULATORS AS A METHOD OF INTERNAL DISINFECTION

John J. Hill, Michael J. Neary; Respiratory Care Services, Deborah Heart and Lung Center, Browns Mills, NJ

Background: Suction Regulators, a standard piece of medical equipment, are implemented in procedures ranging from nasogastric suctioning to thoracic drainage. Most regulators are setup in a manner where a catheter or tube is connected from the patient to a canister. A piece of suction tubing connects the canister to the regulator. Materials removed from the patient are intended to be contained within the canister; however, there exists a potential for suctioned waste to overflow and grossly contaminate the regulator. Contamination inside the regulator may infect subsequent patients receiving intermittent suction. Regulator manufacturers recommend backflushing to clean the internal passageways. This study aims to evaluate the efficacy of these procedures in simulated and real world scenarios. Methods: Regulators from 5 manufacturers were contaminated with a simulated bacterial solution. Each regulator was cleaned according to the manufacturer’s protocol. The regulators were opened and examined under a black light for signs of contamination. As a follow up, regulators in an acute care facility were cultured for bacteria. These regulators were cleaned according to manufacturer’s recommendation and cultured in order to evaluate the efficacy of the procedure. Results: None of the regulators that were contaminated with the simulated bacterial solution were effectively cleaned when following manufacturer’s recommendations. In the second half of the experiment, 36% of the regulators cultured positive for contamination. Bacteria found included S. aureus, S. epidermidis, P. aeruginosa, and B. cereus. After completing each respective backflushing procedure, the regulators still cultured positive. One regulator was autoclave compatible. Upon completing the autoclaving procedure, the culture of the internal lumen did not yield any growth. Conclusion: Regulators have the potential to spread contaminants between patients, thus contributing to the spread of hospital acquired infections. In addition, gastric colonization has been linked to respiratory and systemic infections. Most protocols do not adequately address this contamination problem and may lead to a false sense of security for the hospital and the patient. Only one regulator was adequately disinfected. Without the ability to thoroughly disinfect a suction regulator, situations in which intermittent therapy is applied to a patient could lead to increased costs and patient morbidity and mortality. Sponsored Research - None

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