Hand-Powered Apparatus for Aspiration of Meconium From the Airway

Abstract

In delivery room resuscitation of infants with meconium aspiration, it is common clinical practice to insert an endotracheal tube below the infant's vocal cords and apply suction to the tube directly with the resuscitator's mouth as the tube is withdrawn. Although a surgical mask or sterile gauze is often interspersed between the physician's mouth and the connector of the endotracheal tube, Ballard et al in a recent study found that many physicians bypass such "filters" and as many as 74% reported having ingested secretions during oral meconium suctioning. In several cases, moreover, such secretions were infected with herpes type II, hepatitis B, or Neisseria gonorrhoeae. Although proper application of a mask or gauze over the tube connector may prevent ingestion of secretions, the authors point out that, "some bacteria and most viruses pass through a mask or are readily aerosolized ... and ... a mask moistened by secretions represents an opportunity for exchange of potentially harmful organisms."