Human Factors Associated With the Use of Manual Bulb Suction Devices

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.

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.

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.

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.

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.