Emergency suction equipment: barriers to use and effective interventions

Both investigators had personally experienced situations when they were let down by emergency suctioning equipment on the wards: due to either lack of, or operator inability to use, equipment. Failings in emergency suction have been highlighted in a recent National Patient Safety Agency signal. We focused on improving the usability of cardiac arrest trolley suction: a complex process involving turning a small, hidden lever. We produced three clearly visible bright labels which provided simple prompts to the operator. Two wards and two sampling periods were used in a randomised controlled design. Medical, nursing and allied healthcare staff participated. A scenario of a vomiting patient was given and staff were asked to use emergency suction. This was timed. On the control ward, 5/10 staff members were able to successfully suction on day 1 and the mean time spent trying to activate suction was 43 seconds. On the second sampling day 6 were able to successfully suction and the mean time taken was 50 seconds. On the intervention ward, 7/10 staff members were able to suction with a mean time of 53 seconds spent. Post-intervention, all 10 staff members successfully suctioned with an average time of 30 seconds. The intervention gathered strongly positive feedback. These interventions are being incorporated into sustainable systems changes. Poor equipment design is a needless distraction during an emergency in a busy ward setting. Simple, innovative solutions provide assistance in a pressured situation. Ideally these would become uniform and lead to a culture shift towards simple, intuitive design.