Portable aspirators are an important tool in every first responder’s kit. They’re the first line of defense against aspiration and respiratory obstructions. Yet no medical procedure is without risk, especially with inadequate training or a rushed approach to care. First responders must continually drill the use of portable aspirators so that they're prepared to intervene in an emergency; otherwise, patients can suffer from preventable iatrogenic injuries, some of which can even prove life-threatening. Individualized treatment, thoughtful and comprehensive assessment, and skillful use of portable aspirators can greatly reduce the risk of injury.