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.

Anyone working in patient care knows how important oropharyngeal suctioning is to maintaining airway patency. Not only does it remove bodily fluids (blood, mucus, saliva, and vomit) from the airway, but it also allows visualization of the vocal cords during intubation—a crucial step in establishing an advanced airway.

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.

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 before intubation.

There’s no question that tracheal suctioning saves lives. It can maintain a patent airway in patients with infections who cannot clear their 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.

Every good nurse knows that the job involves much more than simply treating the patient’s current illness or injury. Instead, nurses should try to anticipate potential complications that could arise for their patients and implement measures to prevent them from happening.

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.

Nasopharyngeal and nasotracheal suctioning are safe, effective alternatives to oral suctioning, especially for patients with oral obstructions such as loose dentures or patients who are unable to cooperate with oral suctioning. Though the procedures are similar, nasotracheal suctioning requires deeper penetration. Here’s what you need to know about these two important interventions.

After successful intubation, your patient is mechanically ventilated with a patent airway and his vital signs stabilize. Then, 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.