Medical suction is one of the most fundamental treatments in emergency response. Whether you are clearing vomit from an unresponsive patient, controlling bleeding in a trauma victim, or visualizing the cords during intubation, your portable suction unit is one of the most important tools in your EMS arsenal.
So let’s review a few of the crucial terms in medical suction; some of these focus on the unit itself, and others are related to its role in patient care.
Knowing Your Portable Suction Unit
Portable suction units come in a variety of shapes and sizes, each designed to ensure portability and functionality. Here are a few terms that can help tailor your unit for its intended purpose.
Accessories are a vital factor in outfitting your portable suction unit. They include:
- Catheters: These range from soft, flexible catheters used in nasal or tracheal suctioning to rigid, large-bore catheters for use in controlling copious fluids. A selection of catheters is a must, so that you’ll have the appropriate size and shape on hand.
- Disposables: Suction tubing and canisters must be durable, weather-resistant, and easy to change out, so be sure you have plenty of extras in store.
- Batteries: Your unit is of no use if it doesn’t run, so be sure to keep rechargeable batteries charged and extra alkalines on hand, especially for mass-casualty scenarios. Here are a few battery maintenance recommendations:
- Check batteries at the start of each shift and after each use.
- Test your batteries every few months (according to the manufacturer’s guidelines) and replace if necessary.
- Avoid damage by storing in a dry, safe environment.
- Maintain extra batteries and discard when old or expired.
Portable suction units function by producing negative pressure, which creates a vacuum, evacuating bodily fluids via the catheter and tubing and collecting the fluids in a disposable canister. But like any treatment, there are risks involved. Here are some guidelines to follow when suctioning your patient:
- Maintain universal precautions (gloves, goggles, mask)
- Choose the appropriate-sized catheter, depending on the scenario
- Use sterile technique when suctioning endotracheal or nasotracheal tubes
- Lubricate the suction catheter for ease of insertion when suctioning an advanced airway
- Preoxygenate the patient for 1-2 minutes before suctioning
- Suction for no longer than 10 seconds to prevent hypoxia
- Monitor the patient closely for signs of hypoxia
Suction complications can occur, so be alert for:
- Signs of hypoxia
- Trauma to the airway tissues
- Cardiac arrhythmias
- Increased intracranial pressure
Portable suction units are inherently pathogenic. They contact bodily fluids, including blood, mucus, and vomit, all of which can spread dangerous germs to responders and other patients. To avoid cross-contamination, remember the following:
- Wear personal protective equipment when handling, to include
- Eye protection
- Gown (when necessary)
- Disinfect ALL surfaces of the unit, including control knobs and handles
- Remove from power source before cleaning
- Dispose of all contaminated parts properly
- Sanitize after every use, even when nothing appears in the canister
- Never reuse disposable parts, including the canister, tubing, and catheters
- Use a mixture of bleach and water to sanitize your unit or follow the manufacturer’s recommendations
Keeping your suction unit clean will protect your patients, your coworkers, and yourself, so be vigilant and be sure to disinfect.
Your portable suction unit plays a vital role in preventing hypoxia. But it can also produce hypoxia if not applied appropriately, which is why you should always limit suctioning to under 10 seconds. Stay alert for the signs of hypoxia, which include:
- Increased work of breathing—use of accessory muscles, belly-breathing (in children), nasal flaring, retractions
- Bradycardia (especially in children)
- Decreased level of consciousness
- Inadequate breath sounds
- Abnormal breath sounds (gurgling, wheezing, stridor)
Aspiration, like hypoxia, is an ever-present danger in respiratory emergencies, especially in the presence of:
- Decreased level of consciousness, resulting in an unprotected airway
- Vomiting or GI disorders
- Respiratory/GI devices and procedures, such as a nasogastric or tracheal tube placement
- Dental procedures
- Impaired swallowing, as in stroke or dementia
This review of crucial medical suction terms helps remind us that our portable suction units play a vital role in recognizing, treating, and correcting a broad range of respiratory emergencies.
Pollak, Andrew N., ed. Critical Care Transport, American College of Emergency Physicians, Jones and Bartlett, 2011.å