The mother had turned her back for just a moment—just a few seconds, to wrap up the garden hose she had been using to water her flowers. Her toddler was playing contentedly nearby. The woman was gathering her tools, when she suddenly became aware of the silence. She scanned the yard but couldn't locate the child. She raced to the side of the shed, only to discover her child upside down, trapped in a bucket of water, her small head submerged. It all happened in a few short minutes. Minutes that would change the mother's life forever.
As an emergency medical professional, you appreciate the critical value of time. Some of the most important bodily functions occur in mere seconds: cellular respiration, oxygenation of our tissues, and the neurotransmissions within the brain.
Time also plays a fundamental role in prehospital care. Lights and sirens are utilized, to expedite our arrival and transport. Medications are packaged for expedient access. And our equipment is designed for portability so that we have everything we need when we reach the patient. And one of the most valuable pieces of equipment is your portable suction unit.
It Pays to Be Ready
When was the last time you assessed the expedience of your emergency responses? Most departments track response times of their units: how quickly they respond, how rapidly they arrive on scene, and the time it takes to have the patient packaged and transported. These parameters allow us to gauge our response effectiveness and target areas of improvement.
But what can you, as an individual, do to improve your efficiency, especially on ALS scenes? Here are a few suggestions:
- Check out your equipment – Be sure each piece of equipment is present, clean, and in good working condition, at the start of EACH shift.
- Know your equipment – If it's been awhile since you've used a piece of equipment, or if new gear has been added, pull it off the truck and review with your crew. This will promote familiarity and fluidity on emergency scenes.
- Preplan your assignments – Ensure each member of the team knows his or her responsibility on scene. At the start of each shift, designate who will handle the airway, who will push the drugs, and who will perform compressions. This will ensure each code runs smoothly.
Have the Right Tools
Even if you make good time arriving on scene, reach the patient quickly, and initiate treatment expeditiously, you'll be of little use to your patient if you don't have the right equipment on hand. And one of the most important tools is your portable suction unit.
The most important factor when implementing suction is to have the unit with you on scene. Here are a few recommendations:
- Store the portable suction beside other ALS equipment, to ensure it is included in the ALS assemblage.
- Designate someone to grab the suction on any call where it might be needed. This includes:
- Respiratory calls – to remove secretions and obstructions
- Cardiac – to assist intubation
- Trauma – to remove blood, tissue, and teeth
- Check the unit, to confirm it is operational. This means:
- Batteries are fully charged; if not, replace them.
- The unit is clean and disinfected (after each use!).
- All components are in place, including tubing, catheters, and suction canister.
- Be sure an assortment of catheters is on hand, depending on patient needs, and that it includes:
- Narrow tips for small airways (pediatric and geriatric)
- Large bore for vomit, clots, and trauma
- Special angled catheters for difficult, anterior airways
The most important thing to remember about your portable suction machine is to have it with you at all times. Today's units are small, lightweight, and portable and can even fit in an airway or trauma bag. Time is of the essence in EMS. Your patient may not be able to afford the time needed to run back to the truck to retrieve the suction, so be sure to bring it along on every call.