There is an easier way to maintain GI suction on a post - op patient suffering from a paralytic ileus. I'm not talking about those plug in "portable" machines that weigh 1/2 as much as your patient. There are few pieces of medical equipment that generate a more annoying buzz saw noise than portable suction machines. A bone saw in action might sound worse, but at least the patient does not hear it.
Electrified suction machines in action remind me of the time a yellow jacket flew inside my full coverage motorcycle helmet while cruising on Lake shore Drive. You can't turn off a buzzing suction machine when suction is necessary and you can't remove a helmet in heavy traffic. Meanwhile that persistent buzzing is driving you nuts.
In old diploma nursing schools, instructors like Miss Bruiser, my all time favorite, frequently said that we should learn how to do something "just in case." Students were required to "learn" how to smoke cigarettes so we could better relate to psych patients. Other various hacks were part of the "just in case" curriculum like using sterile finger cots to perform procedures in the event we ran out of gloves.
We were also taught how to construct a do-it-yourself Wagensteen suction using 3 large glass bottles, rubber tubing and a glass drinking straw "just in case" of a power failure. Old hospitals had no backup power supplies. The principle underlying manual Wangensteen suction was Boyle's gas law which stated there was an inverse relationship between pressure and volume. As the water flowed out of the glass bottle on top, a negative pressure was created by the increase in size of the void within the bottle. A glass drinking straw inserted through a hole in the stopper served to harvest the vacuum created by the falling water
The clothesline pulley on top of
the stand facilitated bottle exchange
A more elegant system involved a pole outfitted with an ordinary clothesline pulley which according to my notes could be obtained at any hardware store. A length of rope about 7 feet long was attached to each bottle and threaded through the clothesline pulley assembled at the top of the pole.When the bottles needed exchanged after draining, a nurse could swap their position with a not so gentle tug on the connecting rope. As the bottles made their up and down journey continuous suction was maintained as water continually drained from top to bottom. Dr. Owen Wangensteen, the inventor would have been most proud.
There is something to be said for simple devices cobbled together with a nurse's two hands. Wangensteen suction was a breakthrough discovery in the 1930s that reduced operative mortality from 44% to less than 20%. Owen Wagensteen should have received the Nobel Prize for medicine in 1931, but they gave it to someone who discovered an esoteric enzyme. Simple, silent devices like this suction engender those immersive, visceral feelings old nurses experienced from directly helping someone feel better even if the nurse was too busy yanking on the clothesline to take a break for a Coke and a smoke.
A true classic OFRN. The last episode of the MASH television series had a scene where Hawkeye and Radar O'Reilly rigged up a suction apparatus just how you described. Not so sure about the inclusion of the clothesline pulley to rotate the bottles back and forth. A true stroke of genius.ReplyDelete
When I was a young nurse (Oh..so long ago) I sometimes thought that nurses much older than me were not the sharpest straight Mayos in the instrument tray-so to speak- but just because they lacked the latest technology did not mean they weren't very smart. Old nurses were experts at maximizing the limited resources and knowledge at their disposal.ReplyDelete
The wife of a friend of mine volunteers as an RN on the Mercy Ships that offer desperately needed surgery to poor people in various African countries. She's the same age as me. Her husband tells me she is considered very valuable on the Mercy Ships as they are often without the latest technology in areas and the young nurses don't know what to do - she is used to improvising and reusing equipment and he says the young whippersnippers would be lost without her old-time RN expertise.ReplyDelete
So you see OFRN we do have our uses even today! Cheers, Sue
I enjoyed haring about your resourceful friend. With all the regulatory busybodies in healthcare today, I suspect lots of our hand made items like Montgomery straps or scultetus binders would not pass muster.ReplyDelete
I thought I'd say Hi and I hope you're OK OFRN - we certainly are living in interesting times, as the saying goes. This virus business is a mess. I hope you are staying OK. Best wishes from Sue in Australia.ReplyDelete
Thanks for thinking of me Sue. There are so many unknowns about the corona virus. I really admire all those courageous whippersnapperns out there caring for patients. Nursing can be tough sledding, but I cannot imagine that as a person afraid of contracting a disease caring for someone afflicted with the virus. I never had to do anything like that. Surgeons screaming at me was small potatoes compared to what nurses must do today.Delete
I was into social isolation before it became so popular so I'm doing just fine. I hope the young nurses of today thrive despite the formidable obstacles.
A fascinating post.ReplyDelete
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Remember the old Wagansteens well. As an orderly ( before becoming a diploma RN) during late fifties we had the newest Gomco, but as backup there was a shiny chrome plated Wagansteen 3 bottle system where both upper and lower bottle attached to a long rod on a swivel that rotated top bottle to lower and vice versa. BillReplyDelete
There is something special about elegant simplicity. I fondly recall all the complex surgeries performed with nothing more than a precordial stethoscope and BP cuff. Of course, for the high tech anesthetist there were custom molded ear pieces connected to a stop cock for seamless switching from the stehoscope to the cuff. Thanks so much for taking the time to leave a comment!