A hospital visit can save a patient’s life. It can also destroy it if they pick up a virulent healthcare-associated infection (HAI). Centers for Disease Control and Prevention (CDC) estimates that on any given day, 1 in 31 hospital patients have at least one HAI. 

The Yankauer suction catheter has a long and storied history in both emergency medicine and routine care. Developed in 1907, it has been a mainstay of airway management for more than a century. Dr. Yankauer was a groundbreaking provider in his time, who wanted to carefully suction surgical patients without damaging delicate tissue.

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.

Sooner or later, every nurse must suction a patient. For nurses who work in intensive care units or emergency care or who support patients with spinal cord injuries, suctioning may be a daily part of the job. When suctioning becomes routine, it’s easy to lose sight of the risks. A few simple precautionary measures can reduce the risk and improve patient outcomes. 

Suctioning can be life saving, and may prevent serious complications in the dental office or surgical suite. But suctioning can also be painful and traumatic, especially if the first attempt fails. Suction complications are common and become more likely when you use the wrong suction strategy. These tips can help you choose the right suction strategy for every patient every time. 

When your patient cannot mobilize and clear secretions on his own, you may need to suction his airway. Your method of suctioning will depend on whether the patient has an artificial airway and what portion of the airway needs to be cleared.

Medicine is an ever-changing landscape. As technology improves, new equipment is created that performs better, is safer, and easier to use. Yet, some devices withstand the test of time and have been with us for decades.

As an EMS professional, one of the most critical decisions you will make is when to secure an advanced airway. Airway decisions are crucial: they must be expedient, effective, and appropriate.

Today, paramedics have a range of options when it comes to advanced airways. With the advent of the Combitube and the King airway, there are alternatives to oral or nasotracheal intubation. Oral intubation using an endotracheal tube is still considered the airway of choice, but there are situations where nasotracheal intubation is the better alternative.