With the advent of minimally invasive in-office procedures, patients are increasingly choosing sedation instead of general anesthesia. Sedation exists on a continuum, ranging from very mild sedation to deep sedation, but it is generally safer than anesthesia and requires a shorter recovery time. Patients also may require sedation in some emergency medicine scenarios.

You are called to the nursing home to treat a “patient choking.” Upon arrival, you are rushed to the room of an elderly man who has suffered three previous strokes, resulting in limited mobility and significant speech impairment. Fortunately, the patient is no longer choking. Swift action on the part of the staff prevented an airway obstruction, and the patient is now resting comfortably. But is he truly out of danger? 

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. Some simple precautionary measures can both reduce risk and improve patient outcomes.

Tracheal suctioning saves lives. It can maintain a patent airway in patients with infections who cannot clear their own airway, and it’s a first line of defense against aspiration pneumonia and can prevent hypoxia in patients experiencing anaphylaxis and airway obstructions. Knowing the most common morbidities associated with tracheal suctioning is key to preventing bad outcomes.

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.

Cardiac arrest is a nightmare scenario for most first responders. Recent research suggests survival rates are as low as 6 percent when cardiac arrest happens outside the hospital. Immediate intervention is required, but if suctioning is required, treating a patient in cardiac arrest can be challenging. Here’s what you need to know about the procedure.

When you think of suctioning, you generally think of a straightforward, yet lifesaving, procedure. For the most part, it is a relatively basic skill that can make a world of difference in your patient’s outcome. But even the simplest treatments must be performed using proper technique. As a quick review, the airway is divided into upper and lower structures.

Tracheostomies are increasingly common, particularly in long-term skilled nursing facilities and intensive care units, which means all medical providers must master tracheostomy secretion management. Tracheostomy reduces cough strength, lowers subglottic pressure, and weakens sensations in the pharynx and larynx. This causes secretions to accumulate in the airway, although the volume and thickness of the secretions vary significantly from patient to patient. Medical professionals, first responders, and patients with tracheostomies must learn how to manage secretions to improve patient comfort and reduce the risk of infection, aspiration, and other complications.

Ask any emergency responder and they'll tell you the critical role portable suction plays in maintaining airway patency. No other tool can remove blood, vomit, or sputum from the airway, or allow you to visualize the cords prior to intubation.