More than 17,000 people suffer spinal cord injuries each year, and an estimated 249,000-363,000 Americans are living with spinal cord injuries. A few generations ago, a spinal cord injury was often a death sentence, and almost always meant a much shorter life. Thanks to better medical care and greater awareness, most spinal cord injury sufferers survive, and many go on to live long and healthy lives. Despite these improvements, respiratory issues are common in SCI survivors. Pneumonia is a leading cause of death in this group, often due to complications of respiratory infections and poorly managed airway obstructions. First responders and other providers must be prepared to rapidly respond to airway issues in SCI patients, whether treating the immediate aftermath of a spinal cord injury or providing care to long-term SCI survivors. 

Cardiac arrest is a nightmare scenario for most first responders. Recent research suggests survival rates are as low as 6 percent when cardiac arrest occurs outside the hospital. Rapid administration of CPR drives survival rates up to 45 percent, and the presence of a first responder elevates the survival rate even higher. But suctioning a patient in cardiac arrest can be challenging. Here’s what you need to know about the procedure.

Emergency medicine is constantly evolving, and new technologies and techniques are emerging all the time. With this bombardment of innovation, we sometimes see less value placed on basic skills, such as oral suctioning. As an EMS provider, you must adapt to new technologies and techniques but always fall back on your most basic skills.

Improving your oral suction technique starts with a desire to improve your skills, no matter how basic. Let’s discuss how you can improve basic suctioning skills despite the ever-changing nature of the EMS world today.

After a successful intubation, your patient is mechanically ventilated with a patent airway and his vital signs stabilize. While transporting your patient, you notice a sawtooth pattern to the ventilator waveform. The patient’s cough is not “junky” and his oxygen saturation remains stable. You may be thinking your patient needs some sedation to help him synchronize with the ventilator. But hold on—perhaps you are missing something.

It makes sense that a relatively controlled environment, such as a hospital, has different suction requirements than unpredictable prehospital care environments. Portable suction units are generally thought of as tools to be used in the EMS setting alone and may not be given much thought in the hospital setting. This is an error that hospitals cannot afford to make. Beyond the needs of crash carts and emergency departments, suction units should be a key aspect of the hospital’s disaster plan. Here, we compare the needs of both prehospital and hospital suction units and how the right choice of suction unit can make an impact on both your efficiency and your patients’ outcomes.

Prehospital care providers and emergency personnel understand that even the most basic skill or task is not without its risks to the patient. Because it is a skill taught in basic prehospital classes and may be performed frequently, providers may assume that oropharyngeal suctioning is second nature and does not require the time or effort to improve skills or review safety. However, safely caring for the patient is your priority—and considering various aspects of oropharyngeal suctioning allows you to make sure this fundamental skill remains as safe as possible for all patients, all the time. Let’s explore some safety tips based on these oral suctioning considerations in order for you to provide your patients with the safest care possible.

Although many first responders express reservations about airway suctioning, suctioning the airway is a potentially life-saving procedure that, when correctly performed, has a low risk of complications. With cold and flu season reaching its crescendo and allergy season just around the corner, now is a great time for first responders to brush up on their airway management skills. Continuing education classes and regular drills can prepare you to manage even difficult airways. It’s equally important to be mindful of the most common complications of suctioning. Awareness of these common complications can guide your technique while encouraging your team to remain vigilant and diligent.

Your team’s airway management is only as good as its medical suction units. Diligent practice, exceptional technique, and skillful assessments cannot compensate for a medical suction unit that does not work well. Sometimes fixing suction issues is a simple matter of better storage or keeping an extra battery on hand. In other cases, such as those detailed below, it may be time to replace your suction device.

In prehospital and emergency settings, oral suctioning may be overlooked as a basic task that is performed without harm to the patient. The reality is, oral suctioning is not without its risks and complications. In addition to complications related to the procedure itself, oral suctioning complications may arise because of ineffective or incorrect technique. Let’s explore the various oral suctioning procedure complications and discuss ways you can prevent them in your patients.