Inefficient airway management is causing major problems

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Today, secretion removal is done by inserting a suctioning catheter into the ETT/TT of the patient, and suction out the fluid, secretion etc. below the cuff.

This technique has been around for many years, and exists both as open and closed suctioning systems. Regardless of type, both introduces many problems in critical care, and often experienced clinicians can effectively remove secretions, however, this standard of care still presents multiple issues, such as: 

  • High risk of lung infections.
    The suctioning catheter can only remove fluids and secretion below the ETT/TT tip. Secretion below the cuff and above the tip cannot be removed. This may over time lead to lung infections. 

    The Cuff pressure needs to be checked regulatory to maintain a sealed cuff in order to avoid subglottic aspirations. Often this is not the case, and therefore subglottic aspirations may occur, leading to lung infections 

     

  • Tracheal wall damage.
    When the suctioning catheter is inserted, care needs to be taken to make sure the tip of the suctioning catheter is not damaging the tracheal wall or the upper airways of the lungs, if inserted too deep 
     

  • High risk of loosing PEEP.
    As the patient is being suctioned they cannot be ventilated simultaneously. Therefore, the staff has to be quick when suctioning the patient in order to maintain PEEP levels and return to ventilation. This is not always easy, as the patient may need multiple suctioning's, and this may cause the patient to loose their PEEP. 
     

  • An extremely uncomfortable procedure for the patient.
    The patient is having a "vacuum cleaner" (the suctioning catheter) in the airways. This is very uncomfortable for the patient.
     

  • Excessive workload.
    Even skilled nurses and RTs, experience from time to time, that more tracheal suctionings are needed, and that workload increases. Some patients need more suctioning per day than others, and generally, manual tracheal suctioning requires hands on and time
     

  • Steep learning curve for new staff.
    Even tracheal suctioning may seem harmless and easy to perform, excessive training are required for new nurses or RTs, in order to perform tracheal suctioning effectively

     

In 2019, we (AW Technologies) ​decided to develop TrachFlush, which potentially could remove all the above issues and potentially eliminate the need for tracheal suctioning, and in 2021 we introduced TrachFlush to the market.