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.

Invented in 1907 by Dr. Sidney Yankauer, the Yankauer suction tip has withstood the test of time. The rigid Yankauer suction tip was originally designed to remove blood and secretions from a patient’s oral airway during tonsillectomy procedures. In fact, many practitioners call the Yankauer a “tonsil tip” suction device for this reason.

Oral suctioning in a controlled environment is one thing, but as a first responder, this is a luxury that just doesn’t happen very often. For patients with an airway emergency requiring intubation, you rely on equipment that is efficient, rugged, and safe in order to quickly and safely intubate and secure your patients’ airways. Effective suctioning makes a difference—perhaps even a life-saving difference—in a resuscitated patient. Aspiration pneumonia can occur in up to 50% of out-of-hospital cardiac arrest resuscitations, so what are you to do? Following oral suctioning procedure tips as well as using the best EMS suction equipment available, improves both your efficiency as well as the safe outcomes of your patient.

Airway management is a priority for nurses and first responders alike. A critical component of this is effective airway clearance techniques to manage oropharyngeal secretions. Whether in the field or in a hospital, the how and when of oral suctioning must be mastered in order to ensure the patient's patent airway.