How to Avoid the Most Common Complications of Suctioning

Medical suctioning can save lives, prevent aspiration, and reduce the risk of surgical and dental complications. But as with all medical procedures, suctioning poses some risks, especially with a rushed or unskilled technique.

There are no absolute contraindications to suctioning, though patients with bradycardia, hypoxia, or a history of serious suctioning complications may need additional care and a highly skilled provider. Here are the most common complications of suctioning—and how to avoid them.

Hypoxia

Suctioning increases negative pressure in the lungs. It may also stimulate the vagus nerve. Either can cause hypoxia, particularly if the suctioning is prolonged. In patients already struggling with hypoxia, the risk is even higher. In rare cases, the negative pressure suctioning causes may even partially collapse a lung.

To reduce the risk of hypoxia or lung damage: 

• Preoxygenate a patient before suctioning and before each subsequent suctioning pass. 
• Never suction a patient for longer than 15 seconds. If the first suctioning attempt fails, remove the device and suction the patient again. 
• Use a fully charged, tested machine. When a patient is already hypoxic, suctioning that does not remove an airway obstruction can make hypoxia worse.
  
  
   

Airway Trauma

Suctioning can cause airway trauma that ranges from minor irritation to a life-threatening injury that can become infected or bleed into the airway. These strategies can greatly reduce the risk of airway trauma: 

• Assess the patient for signs of a difficult airway. 
• Use a thin, flexible catheter and choose an appropriately sized catheter for the patient. Pediatric and geriatric patients have more fragile airways and typically need much smaller catheters. 
• Ensure you can see the airway as you insert the catheter. 
• Do not rush suctioning. 
• Monitor the patient for difficulty breathing, airway pain, and signs of airway damage following suctioning. 

Psychological Distress 

Suctioning can be painful and scary, especially in emergency situations or when a patient does not understand what is happening. A compassionate, patient approach can greatly reduce a patient's psychological distress, thereby mitigating the risk of anxiety, combativeness, and long-term issues such as post-traumatic stress disorder. 

 These strategies may help: 

• Remain calm and never threaten or yell at the patient. 
• Avoid restraining or forcing the patient unless it is necessary to save their life. 
• Explain the procedure. 
• Get a support person to sit with the patient. 
• Tell the patient that you are there to help. 
• Be mindful of body language, especially in preverbal children and seniors with dementia who can no longer speak.

Bradycardia 

Bradycardia is a highly prevalent suctioning complication. This is likely because suctioning stimulates the vagus nerve, but other factors may further increase the risk. Ask patients about a history of bradycardia and other heart health issues, and monitor their vitals before, during, and after suctioning.

Be mindful that sometimes bradycardia can be a delayed reaction, such as when a patient stands a few minutes after suctioning.

Ineffective Suctioning

One of the biggest risks is not a complication of suctioning itself, but a failure of adequate suctioning. When a suctioning machine loses power, a practitioner does not know how to adequately suction a patient, or a provider uses the wrong attachments, suctioning may fail.

This can necessitate additional suctioning passes and, occasionally, more invasive measures. Regular training and the right equipment can virtually eliminate the serious health risks of ineffective suctioning. 

Choose the Right Equipment

The right equipment delivers consistent, reliable suctioning so that you do not have to make repeated passes. It is also compatible with a range of attachments, allowing you to choose the right one for your patient.

Portable emergency suction is critical to prompt patient care, allowing you to tend to patients wherever you find them without care delays or risky transports. To learn more about the right machine for your agency, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.

Editor's Note: This blog was originally published in January, 2021. It has been re-published with additional up to date content.