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What This Guide Helps With
Addresses aspiration-line air and unstable suction caused by loose connections, empty fluid sources, leaks, tubing position, occlusion, or suction-path problems.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Continuity of Care
Do not rely on unstable aspiration or blood collection during an active case. Notify the clinical team and provide an alternate method of surgical suction or blood-management support as appropriate.
Expected outcome: Required suction and patient care continue safely while the Cell Saver Elite+ is evaluated.
2. Confirm the Exact Symptom
Determine whether visible air is entering the aspiration line, suction varies unexpectedly, suction stops and restarts, or the system repeatedly indicates an air-related condition.
Observe the entire accessible aspiration path.
Expected outcome: The condition is reproduced or localized to a specific part of the aspiration circuit.
3. Inspect All Aspiration-Line Connections
Check tubing connections from the surgical field toward the reservoir and system. Look for loose fittings, partially inserted connectors, cracked tubing, or disconnected ports.
Expected outcome: All external aspiration connections are secure and intact. If tightening or replacing an external connection eliminates air entry, troubleshooting can stop after verification.
4. Inspect Tubing for Cracks, Kinks, and Collapse
Trace the aspiration tubing for punctures, cuts, soft or collapsed sections, severe bends, or tubing compressed by equipment.
Replace compromised disposable tubing as appropriate.
Expected outcome: The aspiration line is intact and unobstructed.
5. Verify Associated Fluid and Suction Setup
Check clinically managed fluid sources and suction accessories involved in the aspiration setup for empty containers, closed clamps, improper connection, or other obvious external conditions.
Do not change clinical suction parameters without appropriate authorization.
Expected outcome: External aspiration support components are correctly connected and available.
6. Check Reservoir and Disposable Connections
Confirm reservoir ports and disposable connections are properly seated and not allowing air entry. Look for cracked ports, damaged seals, or improperly fitted tubing.
Expected outcome: The reservoir and disposable path are secure. If correcting a connection stabilizes suction, the issue is resolved.
7. Evaluate Aspiration-Line Positioning
Observe whether tubing is sharply elevated, dependent, compressed, or positioned in a way that promotes intermittent flow or air entrainment.
Reposition external tubing without disturbing the sterile field.
Expected outcome: Tubing routing supports stable aspiration without mechanical restriction.
8. Compare With Known-Good Disposable Components
When appropriate, substitute a known-good compatible aspiration line or relevant disposable component to determine whether the instability follows the disposable.
Expected outcome: Stable suction with a known-good disposable indicates the original component was the likely cause.
9. Perform Nonpatient Functional Verification
Using an appropriate setup, verify that suction remains stable and that air is not being drawn into the fluid path from external connections.
Expected outcome: Aspiration remains stable without unexplained air entry. Troubleshooting can stop if the test passes consistently.
10. Remove From Service if Suction Control Remains Unstable
If all external tubing, connections, disposables, and setup conditions are verified but suction remains unstable, remove the system from service.
Label it Out of Service and send it for service-level evaluation.
Expected outcome: An unreliable aspiration system is prevented from returning to clinical use.
If the Problem Persists
External tubing leaks, loose connections, disposable defects, positioning, fluid-source conditions, and obvious aspiration-path restrictions have been ruled out. The remaining cause may involve vacuum generation, suction regulation, sensing, or another internal control condition.
The device should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or bench evaluation
- Evaluated using appropriate manufacturer documentation and approved test equipment
- Repaired or configured only by qualified personnel
Complete appropriate functional testing before return to service. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Maintain an immediately available alternate surgical suction method whenever cell-salvage aspiration is unreliable.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"OR staff reported visible air entering the aspiration tubing and unstable suction during setup."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found a loose aspiration-line connection at the reservoir that was allowing air into the circuit."
Resolution
What action was taken.
Example:
"The connection was secured, and functional testing confirmed stable aspiration without visible air entry."
Helpful Details to Include (If Known)
- Visible location of air entry
- Aspiration-line condition
- Connection security
- Reservoir connection condition
- Kinks or collapsed tubing
- Fluid-source status
- Known-good substitution
- Suction behavior before and after correction
- Final functional test
- Final device status
- Visible location of air entry
- Aspiration-line condition
- Connection security
- Reservoir connection condition
- Kinks or collapsed tubing
- Fluid-source status
- Known-good substitution
- Suction behavior before and after correction
- Final functional test
- Final device status
Final Thought
Air and unstable aspiration should first be treated as external circuit problems until tubing, connections, disposables, positioning, and suction setup are proven sound. Escalate when stable operation cannot be verified.
That is successful troubleshooting.