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Human Factors Associated With the Use of Manual Bulb Suction Devices

O'Neal, Pamela V.; Black, Caroline Bryson; Adams, Ellise D.; Armentrout, Daniel L.

doi: 10.1097/NNR.0000000000000340
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Background Manual bulb suction is commonly used to promote naso-oropharyngeal airway clearance. Human factors of hand placement (radial vs. axial) and relative negative pressure generated are not known. This study is the first step in developing clinical guidelines for safe and effective mechanical use of manual bulb suction to reduce and prevent upper airway injury.

Objective The aim of this study was to determine the negative pressure generated when a 2-oz. manual bulb suction device is compressed and released, and hand placement is either in a radial or axial position.

Methods A total of 87 subjects were recruited using a convenience sampling method to identify hand placement and predicted negative pressures emitted during bulb compression and release. A pressure transmitter system was developed and tested with 666 negative pressure measurements to verify internal consistency and reliability in predicting negative pressure.

Results The majority of subjects compressed the bulb radially (55%). Suction pressures ranged from −42 mm Hg to −81 mm Hg, with a standard deviation of −7 mm Hg. Males tended to have statistically significant higher negative pressures (U = 170, p = .021) when radially compressing the bulb. Females generated statistically significant higher negatives pressures (U = 71.50, p = .001) when axially compressing the bulb.

Discussion A 2-oz. manual bulb suction device creates negative pressures less than 85 mm Hg when using moderate compression regardless of hand placement (radial or axial placement). Further studies are needed to explore additional healthcare provider and patient human factor variables related to the mechanical use of manual bulb suction.

Pamela V. O'Neal, PhD, RN, is Associate Professor, the University of Alabama in Huntsville College of Nursing.

Caroline Bryson Black, PhD, RN, is Part-Time Lecturer, the University of Alabama in Huntsville College of Engineering.

Ellise D. Adams, PhD, CNM, is Associate Professor, the University of Alabama in Huntsville College of Nursing.

Daniel L. Armentrout, PhD, is Lecturer, the University of Alabama in Huntsville College of Engineering.

Accepted for publication September 11, 2018.

Acknowledgments: The authors want to express their appreciation of the engineering students who showed interest and enthusiasm in exploring interprofessional activities with the discipline of nursing.

An institutional review board approved the human subject study. Responsible and ethical conduct of research was maintained through the study.

The authors have no conflicts of interest to report.

Corresponding author: Pamela V. O'Neal, UAH College of Nursing, Room 207 C North Building, 1610 Ben Graves, Huntsville, AL 35899 (e-mail: onealp@uah.edu).

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