Oral suctioning in a controlled environment is one thing, but as a first responder, this is a luxury that just doesn’t happen very often. For patients with an airway emergency requiring intubation, you rely on equipment that is efficient, rugged, and safe in order to quickly and safely intubate and secure your patients’ airways. Effective suctioning makes a difference – perhaps even a life-saving difference – in a resuscitated patient.
Aspiration pneumonia can occur in up to 50% of out-of-hospital cardiac arrest resuscitations, so what are you to do? Following oral suctioning procedure tips as well as using the best EMS suction equipment available, improves both your efficiency and patient outcomes.
Here’s how to get it right.
The Importance of Airway Decontamination
Intubation and oral suctioning go hand-in-hand. But are you using the best equipment and techniques to efficiently intubate? An improved technique called Suction Assisted Laryngoscopy and Airway Decontamination (SALAD), developed by Dr. James DuCanto, uses continuous suction provided by the SSCOR DuCanto catheter.
Using this technique and rigid catheter during all phases of laryngoscopy facilitates successful intubation. The constant suction provided by the DuCanto catheter decontaminates the airway by continuously removing vomit, blood, and other materials while you are intubating your patient. Decontamination of the airway during intubation decreases the risk of the development of aspiration pneumonia after resuscitation, improving your patient’s outcome. Click here to watch the video explaining the SALAD technique using the SSCOR DuCanto Catheter.
While continuous suctioning during intubation decreases aspiration of contaminants, routine suctioning in this manner is not recommended. Continuous routine suctioning is not advised because it can irritate delicate mucosa and increase the risk of infection.
Suction Techniques After Successful Intubation
Although a basic skill, you may not routinely intubate patients and oral suctioning procedures may not be something you perform frequently. Let’s review a few things when it comes to oral suctioning after intubation and some tips on providing safer care related to this procedure:
- Check your equipment. Make sure you have the unit and all disposables together, assembled, and everything is working.
- Remember your PPE. Consider wearing eye protection or goggles—suctioning can get messy!
- Patients should be preoxygenated with 100 percent oxygen to help decrease the risk of hypoxia due to suctioning.
- Maintain sterile technique. This is essential to preventing contamination of the airway with harmful disease-causing bacteria.
- Suction for only 5-10 seconds at a time if possible. Along with preoxygenating, this helps to prevent hypoxia and reduces the risk for cardiac arrhythmias.
- Provide adequate ventilation between suctioning passes to allow for oxygenation and perfusion to the tissues.
- Make sure your patient is connected to the cardiac monitor at all times during suctioning. Arrhythmias from oral suctioning may occur and it’s important to assess the patient’s cardiac rhythm at all times during the procedure.
In addition to your patient assessment after suctioning, maintaining proper equipment storage, cleaning, and maintenance should be your priority. Follow the manufacturer’s instructions for cleaning equipment, and never put away wet equipment, especially in an enclosed area. Dispose of all disposable parts and check to ensure the unit has all necessary parts for the next suctioning procedure. Be sure to check your portable suction unit’s batteries with every shift and perform maintenance according to the manufacturer’s schedule.
Keep your unit clean and sanitized to prevent the spread of communicable disease. As mentioned earlier, be sure to store all essential equipment together – if you don’t, you could find yourself without a disposable or tip when you need it most. This error is something your patient cannot afford when there is an airway emergency.
As with any skill, it is important to practice, practice, practice. Get a good airway mannequin, one that ‘vomits,’ and repeatedly simulate intubation under difficult circumstances.
Safe patient care depends on a unit that is reliable, delivering consistent suctioning with a long battery life. First responders demand a portable unit that’s sufficiently powerful to clear the airway, without weighing down a tactical trauma bag. For help selecting the right portable emergency suction device for your agency’s needs, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.
Editor's Note: This blog was originally published in March 2019. It has been re-published with additional up-to-date content.