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

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? 

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.

Preplanning is part of the job as an emergency responder. Each shift, you must be prepared to answer any type of emergency that your community throws at you, so you had better plan ahead. When it comes to your equipment, especially your pharyngeal suction device, you want a unit that will fit the needs of the community in which you work. Here are a few considerations when choosing a portable suction unit.

There are many medical and traumatic causes for a decreased level of consciousness, any of which can lead to a respiratory emergency. A thorough patient assessment and quick diagnosis, followed by aggressive treatment, can prevent the patient's condition from deteriorating. But even optimal care cannot stave off every respiratory complication.

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.

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.