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Lesson

Airway Suction

10 min Airway & Breathing Skip to quiz

Objective: Pick a large tip for food, blood, and vomit. Clear the mouth before you bag. Stop suction before you use up the oxygen they still have.

Why this matters

The airway is full of food, blood, or vomit, and the bag just sprays it deeper. Crews grab a thin catheter, suction for a long time, then wonder why the sat is 60%. Suction opens the airway so the bag can work. It does not replace position, a seal, and oxygen. You have a portable suction unit, one rigid Yankauer tip, and maybe a flexible catheter. You usually do not have operating-room wall suction. Test the suction you actually have.

Verbalize
  • I turn suction on and test it as I walk up, not after the first failed bag.
  • Food, blood, and vomit get a rigid large-bore tip. A thin catheter will not move a piece of food.
  • I suction for about 10 seconds, or less time than I can hold my own breath. Then I give oxygen and look for chest rise.

Clinical sequence

  1. Have large-bore suction on and in your hand before the look. Do not leave it in the outside pocket.
  2. Clear the mouth first. Use a Yankauer, or a catheter wide enough for the material. A 14-French whistle-tip catheter will not move food, blood, or thick vomit. Your protocol owns the catheter size.
  3. Suction on the way in. Do not push the blade into a pool of vomit or blood. If fluid keeps coming, roll the patient, suction again, and bag or place a supraglottic airway as soon as you can get oxygen in. Do not keep looking while you are not giving oxygen.
  4. Use a flexible catheter for the tube, or for a measured pass in the mouth after the big material is gone. For the mouth, measure from the corner of the mouth to the earlobe or the tragus. For an endotracheal tube, insert only to just past the tube tip. A deep blind push can cause a slow heart rate and bleeding.

Teaching points

  • Short and large-bore, then bag and reassess. Do not suction until the patient turns blue, and do not suction for a continuous minute.
  • The flexible catheter does not replace the Yankauer when the mouth is full, and it does not replace the bag.

Common errors

  • Bagging into a pool of vomit instead of rolling and suctioning first.
  • Using only the thin tube catheter when the mouth is full.
  • Suctioning so long that the next problem is a low sat, not the original material.

Practice

One-minute check

Partner gives three cases. (1) Food in the throat, and a pulse is present. (2) The patient is intubated, and you suddenly hear gurgling in the tube. (3) There is a large amount of blood, and suction is not turned on. For each, name the tip you use and the next plan for breaths.

Related: Effective BVM, DOPE-S.

Sources & Further Study

Named guidelines for further study. They are not clinical orders and do not replace your protocol or medical direction.

Education only. Apply learning within your protocols and medical direction. This is not clinical care guidance.

Check Your Understanding

Questions drawn only from this lesson. After you check, the key is highlighted. Education practice — not a certification exam.

1. The mouth is full of food and vomit. Best first suction tool on a typical ambulance:
2. A common teaching limit for a suction pass is:
3. Flexible catheters are mainly for:
4. Suction that actually helps ventilation is:
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