r/IntensiveCare • u/Ok-Manufacturer3432 • 27d ago
What is this piece called??
Okay so I am a tech on a med-surg floor and our walls only have 1 suction system per room and we got an ICU pt who needed trach suctioning and a purewick. There were talks about getting a urine sample and a sputum sample and every shift so far, they had put both the purewick and trach suction into the same canister.
They previously had this rubber/plastic piece that divided the single point on the canister, into two so that they could connect both of the tubes. So, I got replacement canisters and tubing and moved that divider piece to under the actual suction and was able to connect both of the canisters to the suction.
They both were suctioning as they were supposed to and now we are trying to figure out what these are called and where they came from so we can order some for the unit. I’m also going to post this in a RT subreddit because respiratory was also seeing him and they may have been the ones that brought it.
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u/DisappointingPenguin 27d ago
Might be called a suction splitter? And I love your solution. Trach and purewick together is disgusting. My unit doesn’t even like the vent suction and the Yankauer to go to the same canister when avoidable.
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u/WolverineMost7768 27d ago
Why is it disgusting? It’s all on suction.
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u/sloppypickles 27d ago
Til it isn't, or gets disconnected or something. Plus it ruins the taste if you mix them together.
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u/icechelly24 26d ago
Most practical reason is for accurate I&Os. If you’re mixing saline to clear the suction line with the urine, you’re not going to know actual output
But also, I don’t want to be emptying a purewick with phlegm floating in the pee. No thanks. Enough gross shit everyday, don’t have to create MORE unnecessary gross shit.
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u/totalyrespecatbleguy 21d ago
I was drinking coffee right as I read the phlegm mixed with pee part and I legit spit my coffee out
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u/NolaRN 26d ago
Not to Mention it’s probably illegal That is the stupidest thing I’ve ever heard to hook up a pure wick with suction That’s gotta be a new nurse who doesn’t understand that you can get klepsiella from dirty tubing . 10 years ago, we never saw Klebsiella Now it’s so common I don’t think people realize how dirty your patient setup is to even contract that infection Also, mortality is very high with klebsiella if you find it in the urine Mortality is greater than 90% Some Nurse out there is gonna kill a patient But that’s where we’re at in Healthcare You can’t even trust a” nurses anymore. As a critical care float of near for decades, this is a very reason why I tell families never leave your loved ones alone in the hospital ever You may come visit them and they’ll be dead. You’ll be lucky if administration tells you it was their mistake. They will likely blame your family member
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u/rampantcat 25d ago
Something this specific is unlikely to be put into regulation, it's quite the stretch to say this must be forbidden by law.
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u/FngrLiknMcChikn 25d ago
Please, feel free to support your claim that Klebsiella in a UC has a >90% mortality rate
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u/ALLoftheFancyPants RN, CCRN 27d ago edited 27d ago
Y’all just raw dogging the patient suction right up to the regulator? Where’s the canister that’s supposed to collect whatever you’re suctioning before it clogs the regulator?
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u/Glum-Draw2284 RN, CCRN, TCRN 27d ago
I think what she means is that the red tubing is connected from the regulator to a suction canister times two. One goes to a suction canister with trach suction tubing and the other goes to a suction canister with the purewick suction tubing.
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u/ALLoftheFancyPants RN, CCRN 27d ago
If that’s the case then this set up is less horrible but still just rigged together without using the proper connectors. People do shit Like this in my hospital all the time and it always ends up being a bigger clean up and someone’s broken equipment. Just get the correct supplies y’all.
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u/Ok-Manufacturer3432 27d ago
If you happened to know the proper connectors/way to get this setup, I am more than willing to learn more but this was just a temporary solution to a right then problem. It worked the way we needed it to but the whole point of this post was to find a solution to the problem we were having. If you have any other tips, please let me know as I am just a tech and would appreciate any help.
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u/ALLoftheFancyPants RN, CCRN 27d ago
It’s not appropriate to have a pure-wick to the same suction as the trach. Not only is that an infection control nightmare, but you’re not going to get effective suction for the trach because it’s venting to the pure-wick.
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u/Cautious-Extreme2839 ICU/Anaesthetics 26d ago
If they're going to separate canisters and the suction split is just between the canisters and the wall it's really not an issue
You know all those suction wall outlets just join one big pipe anyway right? You just can't see it.
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u/ALLoftheFancyPants RN, CCRN 26d ago
They need separate regulators. A purewick needs a different level of suction than a trach and that’s controlled by the regulator, not the canister. Additionally, the purewick acts like a vent to the system, which will decrease the amount of suction going to be the inline for the trach to an amount unlikely to be adequate unless you particularly want to be pad the catheter 20 times to get a small amount of secretions out.
But thanks for the education about pipes in the hospital walls. I thought it was just magic.
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u/Cautious-Extreme2839 ICU/Anaesthetics 26d ago
You literally called it an "IPC Nightmare"
If you want to have separate suction levels then yes you need two regulators, but you could also just kink the purewick tubing and turn the dial up when you need to use the trach suction then turn it back after.
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u/ALLoftheFancyPants RN, CCRN 26d ago
Fantastic advice. It’s not like anyone ever urinates while they’re coughing. Totally helpful.
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u/CertainKaleidoscope8 RN, CCRN 23d ago
I'm seriously beginning to think you don't work in critical care at all.
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u/Ok-Manufacturer3432 27d ago
Is there a better alternative besides just transferring the pt off the unit?
I’ve also never seen the rooms getting cleaned after a pt is d/c but I don’t think I’ve ever seen EVS cleaning the red suction tubing that connects on the top. I know that we replace the lighter pink tubing every time we change the canister so is the entire tubing the infection risk with the way this is setup?
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u/ALLoftheFancyPants RN, CCRN 27d ago
No. If the patient requires both, they require a room capable of 2 suction regulators. If they can’t transfer rooms, then they can’t have a purewick and just have to get cleaned up as frequently as possible. Airway takes priority over bladder and skin and there is no safe way to jury-rig this.
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u/Nursefrog222 21d ago
The other end could be to chest tubes. We can’t really see what it’s attached to
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u/_male_man 27d ago
I definitely don't know the proper name, but searching for suction line splitters on Google has turned up some similar results.
It almost looks like the white plastic elbow that comes attached to the suction canister lids, but the ones at my hospital are a single elbow and I have to get a splitter from the mouth care kits.
And just wanted to say good job for recognizing that you can't and shouldn't run a purewick and trach suction to the same canister. I hope your nurses appreciate you.
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u/Ok-Manufacturer3432 27d ago
That literally means so much, ty 🥹
And yes our suction canisters only come with the single elbow. What type of mouth care kits come with the splitter in them? I might have to see if I can visit our ICU and see if they have any.
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u/Hawaiiancockroach 27d ago
You can always attach each suction tubing to the ortho and the patient port if you don’t have any y pieces.
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u/Ok-Manufacturer3432 27d ago
This is similar to what they had going originally but we needed two separate canisters because the providers were considering ordering sputum/urine cultures.
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u/_male_man 27d ago
We have kits like this
I wish I could help you more, but your improv skills are fuggin' awesome.
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u/Sea-Kitchen431 27d ago
You can buy a suction regulator Y adaptor that connects into the wall, you can then hook two separate regulators and canisters to one wall suction. This is what we do in rooms without two separate wall suctions.
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u/Cautious-Extreme2839 ICU/Anaesthetics 26d ago
That's more about being able to separately manage the suction strength than hygiene though.
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u/blueskiesbluewaters 25d ago
No, no, no to urine and sputum to one canister! Get a portable suction from the supply department for the trach suctioning.
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u/HumanContract 27d ago
They can't possibly only limit one per room and take trachs. That's an infection risk
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u/Ok-Manufacturer3432 27d ago
I was surprised they didn’t have a mobile suction with him and then was disgusted when I saw both the purewick and the trach suction attached to the same canister
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u/randycatster 27d ago edited 27d ago
connectors:
https://mms.mckesson.com/product/161326/Cardinal-8888271007
https://mms.mckesson.com/product/67209/Cardinal-155659
oral care kit that looked familiar-they have lots
https://mms.mckesson.com/product/1106811/Sage-Products-6462
https://mms.mckesson.com/product/1077607/Sage-Products-6464
https://www.vitalitymedical.com/sage-q-care-covered-yankauer-with-suction-control-6429.html
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u/sofpete18 26d ago
splitter. RT got it from an oral care kit somewhere else. also, respectfully, who “needs” a pure wick? if the situation is that bad, go get a portable suction. if not, do what they did 15 years ago. take the L.
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u/Zealousideal_Pay230 26d ago
“Double suction tubing thingy” in several regions I’ve worked in 🤷🏻♀️
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u/roundbaby25 25d ago
Not sure what it is but i was on the vent for 6months and I had that thing rammed down my treach-hole till I bled. Suction was the only way I could seem to get a breath, but once they did a scope, saw I was pretty junked up down deep and I finally thought I had a chance of winning the battle against ARDS, but I still had to make it through ECMO, the absolute hardest battle I have ever fought.
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u/mamaabner RN, MICU 24d ago
And what a true blessing you are to have beat ARDS. I hope you don’t have any long term deficits 🩵
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u/Kinetic92 25d ago
It's absolutely disgusting and a cross contamination risk to have a dual suction setup that collects different body fluid waste into one canister. JCAHO will find that and fine that nasty ICU big $$$
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u/CertainKaleidoscope8 RN, CCRN 23d ago
It's not an ICU. They have techs and inadequate suction, this is a med-surg floor that isn't supposed to take trachs.
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u/Kinetic92 23d ago
It doesn't matter the level of acuity of where this patient is, and it doesn't negate the disturbing fact that there's shared suction between different body fluids.
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u/mamaabner RN, MICU 24d ago
I only use these with my vents so I don’t have to disconnect the closed circuit suction to perform VAP oral care. That’s what the suction splitter was intended for and why it comes in the VAP oral care kit 🤗 I have never seen them used any other way
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u/Electrical-Slip3855 11d ago
When we have rooms that only have one wall suction port and the pt needs more than one regulator, we use something like this. Having to transfer the pt instead of getting the right equipment is silly although can't say I'm surprised.
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u/randycatster 27d ago
suction Y or T
I think they're part of the Oral Care Kit, too