The code is running smoothly, even though you have yet to secure an endotracheal tube. You are hastily setting up your airway equipment, good CPR is in progress, the patient is being bagged, when suddenly the vomiting ensues. Fortunately, you’ve brought along your portable suction unit. You crank it on and get to work, but the vomit is proving a challenge. Instead of using a large-bore suction catheter, you’re stuck with only a small-tipped rigid catheter, which is rapidly losing the battle against the patient’s gastric contents.
Suddenly, the tip becomes clogged, your suction unit begins to fail, and your patient is placed in mortal danger. If only your suction tip had remained patent.
As a medic, you know you will face challenges in the field. Things go wrong. The patient doesn’t respond to drug therapy, you can’t get the tube, and equipment sometimes fails. But there are ways to minimize complications, and when it comes to suctioning your patient, the best defense against a clogged suction tip is to use the right equipment from the start. Here are a few preventive measures:
- Choose a high-quality suction unit. Never cut corners when it comes to your portable suction unit. Quality counts, so make sure your unit is powerful, effective, and reliable. It must be able to stand up to the demands of EMS, while providing the flexibility to adjust to any type of patient, be they geriatric or neonatal.
- Always have suction on hand. You never know when you will encounter a compromised airway. Even a stable patient can suddenly crash, especially if he or she is unresponsive and incapable of protecting his or her airway. It’s your job to guard against aspiration, so be sure you have your portable suction unit at the ready.
- Use variable-sized catheters. There is no “one size fits all” when it comes to suction catheters. A small tip is ineffective against blood clots, vomit, or tissue. For example, your patient is involved in a head-on collision. He has massive facial trauma, is losing consciousness, and you’re working in the confines of a crushed car. Luckily, you were wise enough to carry along your suction unit, but it had better be small and effective in order to meet the challenges of this call. A bulky unit will only be in the way, but you don’t want to compromise size for strength. So, choose a unit that is compact yet powerful. And you had better have a large-tipped catheter on hand, one that can clear this most difficult of airways.
When it comes to a clogged suction tip, your best defense is prevention. Choose a reliable portable suction unit, have it with you at all times, and use an appropriate-sized catheter so that a clogged tip is less likely.