An emergency aspirator can save lives. It can also be intimidating to patients, and first responders may be reluctant to use the device in the absence of clear indications. There is no reason to deny or delay suction to a patient who shows an obvious need. So when should you use an emergency aspirator? The short answer is that an emergency aspirator may be appropriate any time there is any sort of airway obstruction. Here are some of the most common usage indications.
Excessive Secretions the Patient Cannot Clear
Any time the patient has excessive respiratory secretions that they cannot clear, an emergency aspirator is appropriate. A rattling or raspy sound when the patient talks, hoarseness, or a wet-sounding cough may signal excessive secretions. Additionally, if the patient indicates they are struggling to breathe and need help clearing the airway, an aspirator is appropriate.
Vomiting
A patient who is continuously vomiting or bleeding, especially if they already have a respiratory obstruction, is at risk of aspirating. Vomiting in an unconscious patient or a patient who is seizing is often an emergency. An emergency aspirator can clear the airway and lower the risk.
Airway Obstruction from Traumatic Injuries
Airway trauma can be life-threatening and may lead to an airway obstruction. Someone who has suffered a blow to the neck, a gunshot wound, a head injury, or another physical trauma may need assistance clearing the airway. Clearing the airway with an emergency aspirator can also help with visualizing the location and severity of the injury.
Suspected Aspiration
Aspiration is a serious and potentially life-threatening emergency. Certain patients, including those with dysphagia and other swallowing disorders, face a heightened risk. A patient who shows signs of aspiration may need to have their airway cleared. Some signs of aspiration include:
- Chest pain
- Shortness of breath
- A hoarse, rattling cough
- Green sputum
- Very foul-smelling breath
- Fever
- Cyanosis
- Excessive unexplained sweating
- Unexplained fatigue
If you know a patient has aspirated, don’t wait for them to show symptoms.
Contraindications for Suctioning
There are no hard and fast contraindications for suctioning, and denying suctioning to a patient can endanger their life. However, some medical conditions can make suctioning more difficult. In these situations, first responders should proceed with caution, and the most experienced team member should perform the procedure. Conditions that may increase risk include:
- A prior history of airway trauma. This may indicate an unusual or difficult airway. It may also increase patient anxiety about suctioning.
- Cardiac arrhythmias. This increases the risk of cardiovascular issues following suctioning.
- Traumatic injuries to the face or skull. This can make suctioning more difficult. Suctioning can also exacerbate these injuries.
- Mental health conditions, developmental disabilities, and dementia. These conditions can make it difficult to get the patient to follow instructions. They may also increase the risk of trauma, pain, and psychological distress.
- Spinal cord injuries. Moving a patient with a recent spinal cord injury can be dangerous.
Careful monitoring during and after suctioning can greatly reduce risk. It’s also important to explain the procedure to the patient in terms they can understand. Be patient and empathetic. Take your time, and only suction an airway you can see. Many suctioning emergencies are chaotic and stressful, but rushing the procedure only endangers the patient.
Perhaps most importantly, ensure you have state-of-the-art equipment that delivers efficient, effective, and safe suctioning. Your suction machine should be compatible with all attachments. It should also have a reliable battery, and you should store it with all attachments and other supplies to increase ease of use.
For help selecting the right emergency aspirator for your organization, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.
Editor's Note: This blog was originally published in February, 2019. It has been re-published with additional up to date content.
