Potential Complications of Oropharyngeal Suctioning

As a paramedic tasked with performing lifesaving treatments in the field, you know that every procedure you perform has potential complications. The tenuous IV you establish in the geriatric patient may blow; the tube may become dislodged during transport; or the cardiac rhythm may simply refuse to convert, no matter what medication you try. These are just a few of the hurdles you face as a paramedic administering care in emergency situations. And even the simplest of treatments can pose complications under the trying conditions in which you work.


For example, oropharyngeal suctioning. Suctioning your patient is one of the most fundamental, yet imperative, treatments you can render. Nothing is more essential than clearing the airway, and nothing can perform the job as well as an effective portable suction unit. But still, there are complications. And these complications aren’t simply the deleterious effects imposed on your patient. As with any field treatment, it all starts with equipment readiness.


As skill levels increase and treatment protocols become more advanced, the equipment employed by paramedics must keep pace with this ever-changing field. And portable suction units have come a long way. They are lighter, more compact, and more effective at clearing the airway, providing emergency responders with an essential tool in their airway toolkit. But like every tool, proper maintenance is imperative. So to prevent complications when preparing to suction a patient’s airway, make sure the necessary equipment is ready to do the job. Here are a few critical steps in ensuring your portable suction unit is ready for action.


Maintenance Is Key!

  1. Check it out—be sure to go through a thorough checkout at the beginning of each shift, including:

  • Powering the unit up
  • Switching out dead or low batteries
  • Inventorying accessories, such as a variety of suction catheters

  1. Bring it with you—always keep your suction unit on hand, which is easy when you include it as part of your airway bag.

  2. Keep it clean—be sure to disinfect your unit after each use, to ensure it is safe for both you and your patient.



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Effective Suctioning

Now that you know that your portable suction unit is ready for service, here are a few reminders for proper usage:

  • Choose the proper catheter—gauge the size of the catheter based on the condition of your patient. If the patient has simple secretions, such as saliva, a small-bore catheter is just fine. But if you’re working on a trauma patient who has heavy bleeding along with tissue and clots, a larger-bore suction catheter will be much more effective.

  • Choose the proper suction level—even a skill as basic as suctioning must be administered with precision. You wouldn’t crank up the suction on a geriatric patient with fragile oral tissues or on an infant in distress. The safest practice is to dial it back for such patients, and the most efficient way to achieve this is by having a portable suction unit with adjustable negative pressure.

  • Use with care—always remember that even though suctioning your patient is a simple skill, it still poses a threat to your patient if not performed properly. Here are some essential reminders:

    • Limit suctioning to less than 10 seconds: Follow this rule of thumb to prevent getting carried away when clearing the patient’s airway. Lengthy suctioning can cause hypoxia, so suction frequently, but with this critical time factor in mind!

    • Avoid aggressive suctioning: Today’s portable suction units are powerful and can cause damage to delicate oral tissues. Guide the suction tip carefully to prevent tissue tears, especially in older patients.

    • Watch for dental hardware: Be sure to stay alert for dentures and bridges when suctioning your patient, for if dislodged, these dental prosthetics can block the airway.

All emergency treatments have complications, but through good preparation, proper maintenance, and effective practices, suctioning your patient can be not only safe but lifesaving.