Home ventilation: practical information about the suction device, tracheal cannula and oxygen therapy

Suction device

How do I install the suction device?

Connect the device to a power socket.
The device also has an internal battery, so it can be used outdoors.
You can set the suction pressure yourself: max. 200 mm Hg.

Suction catheters and tubing

The hospital will provide you with enough catheters.
- Need new catheters? When your ventilation and suction devices are checked at home every six months by a technician from the biomedical department, they will bring new catheters for you. You can also collect them yourself at the sleep centre.
You will receive a tube and a spare tube from the hospital. These tubes have a diameter of 6.5 mm and can also be purchased at a DIY store. The T-connector between the tube and the catheter is also provided by the hospital.

Reusing catheters

You may only reuse catheters if they are thoroughly rinsed after each suction with a 3% HAC solution (30 ml HAC in 1 litre of water) and then stored dry in their packaging. Use a maximum of 1 catheter per day.

Suction technique

At the sleep centre, you will learn how to perform suction. Some practical tips:

Do not apply suction while inserting the catheter.
Insert the catheter approximately 20 cm deep.
How often suctioning is needed depends on the individual.
After suctioning, the patient should take a deep breath.
Check the colour of the mucus: consult your GP if there are changes in colour or quantity.
If the mucus is too thick, you can slightly increase the humidifier setting. However, ensure that this does not create too much condensation (water) in the tubing system.

Hand hygiene during suctioning

You do not need to wear sterile gloves when suctioning at home.
Try not to touch the part of the suction tubing that is inserted.
Always wash your hands before and after suctioning.

How do I maintain the suction device?

Empty and clean the mucus collection jar daily using a diluted HAC solution (e.g. 3% HAC available at the pharmacy).
Rinse the tubing, T-connector and suction catheter thoroughly with the diluted HAC solution after each suctioning. Do this by aspirating a small amount from a designated jar.
Electrical and mechanical maintenance of the device is carried out by the hospital's biomedical department every 6 or 12 months (together with the check of your ventilation device).

What to do in case of malfunction?

First check carefully whether:
- the collection jar is properly connected;
- the tubing is properly connected;
- there are no leaks in the jar or tubing.
If the motor of the device is broken, contact the sleep centre.

Tracheal cannula

A tracheal cannula consists of three parts:

the outer cannula (which remains in the trachea)
a mandrel (used to insert the outer cannula)
the inner cannula

Care around the cannula

Use small sterile compresses and a disinfectant solution (e.g. 3% HAC, available from the pharmacy).
Apply a clean compress around the cannula at least once a day.
Cannula tape: you buy this yourself (1 to 2 cm wide).
- Replace the tape when it is dirty.
- Cut the tape on both sides while holding the cannula firmly.
- Attach the new tape and tie it.

Care of the inner cannula

Clean the inner cannula once a day.
- Disinfect the inner cannula by immersing it in a stainless steel bowl filled with HAC solution (for about 30 minutes).
- In the meantime, insert a spare inner cannula.
- Rinse the cannula under running tap water.
- Thoroughly dry the inside and outside using tweezers and a dry sterile compress.
- Store the inner cannula in a dry stainless steel bowl (preferably with a lid) until you need it again.
- Boil the stainless steel bowl and tweezers once a week.

Oxygen therapy

Oxygen is only administered on medical prescription.

This applies to patients who are not ventilated during the day but do require oxygen via nasal cannula, mask or nasal tubing.

During ventilation, oxygen is delivered via an intermediate connector on the tubing system or directly on the ventilator.

Three possible systems and their equipment

Oxygen cylinders
- Oxygen cylinder
- Manometer, pressure regulator, flow meter
- Nasal cannula, mask or nasal tubing
Oxygen concentrator
- Oxygen concentrator (electrical device)
- Nasal cannula, mask or nasal tubing
Liquid oxygen
- Liquid oxygen and oxygen vaporiser (easy to handle, lightweight device)
- Nasal cannula, mask or nasal tubing

Oxygen cylinders

Oxygen cylinders are rented at the pharmacy on prescription from your GP. After arranging with the company, the cylinders are delivered to your home. The contents of the cylinders (= compressed oxygen) are reimbursed.

Make sure you always have a full spare cylinder at home.

The accompanying manometer, pressure regulator and flow meter can be borrowed from your health insurance fund or pharmacy. You can also purchase the equipment from a medical supply company. Ask your healthcare provider or pharmacist for more information.

How does it work?

The oxygen is compressed under high pressure in the cylinder. For example: a 10-litre oxygen cylinder can contain 1,500 litres of oxygen.
A pressure regulator is fitted to the cylinder to produce a usable oxygen flow.
The amount of oxygen needed during ventilation or at other times is prescribed by the doctor. You must never increase this amount yourself without medical advice.
You can read the pressure in the cylinder on the manometer and calculate how many litres of oxygen remain.
Use the flow meter to set the amount of oxygen to be delivered (= litres per minute).

An oxygen cylinder has a capacity of 10 litres.
The pressure at which the oxygen is compressed is 150 Pa (bar). The full cylinder therefore contains 1,500 litres of oxygen (10 x 150).
If a patient receives 2 litres of oxygen per minute, the cylinder will last 750 minutes (1,500 litres / 2 litres) with this bottle. That's 12 times 60 minutes, i.e. 12 hours.

If you have trouble connecting the pressure regulator to the oxygen cylinder, do not use oil or grease to make it easier. Contact between high-pressure oxygen and grease can cause fire.
Beware of smoking: oxygen will intensify any small flame. Never use oxygen near an open flame.
Ensure that the oxygen cylinder is stable and cannot fall over.
First open the small valve of the flow meter before opening the cylinder valve. Excess pressure can damage the regulator.
Never stand in front of the oxygen valve when opening it.

Nasal cannula, mask or nasal tubing

These items can be purchased from the pharmacy.
Ensure the equipment fits well; otherwise, it may irritate the nose.
If oxygen therapy is required, the ventilator will be fitted with an oxygen reservoir and oxygen connection.

Oxygen concentrator or liquid oxygen

In consultation with the doctor, it is decided whether a concentrator or liquid oxygen is required. The patient must meet certain strict criteria. The application is always initiated by the hospital’s pulmonary function testing department ("longfunctiemetingen").

Use of these devices is free of charge.

How does it work?

The oxygen concentrator works by concentrating oxygen from ambient air.
When using liquid oxygen, the patient has a small portable device that is filled with liquid oxygen.

Also read

The ventilator

How do you use and maintain the ventilator, the optional humidifier and the tubing system for home ventilation? Which alarm signals can you try to resolve yourself?