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Lesson

Suction That Actually Clears the Airway

10 min Airway & Breathing Skip to quiz

Objective: Pick the right suction tip, clear the mouth before you bag, and know when suction is stealing oxygenation time.

Why This Is Hard

The airway is full of steak, blood, or pregnancy vomit and the BVM just sprays it. Crews grab a skinny catheter, suction for 20 seconds, then wonder why SpO2 is 60%. AHA 2025 adult BLS: suction is part of opening the airway so ventilation works — it is not a substitute for position, seal, and oxygen.

On this truck
  • You have a portable suction, one Yankauer, and maybe a flexible catheter for an ETT/SGA.
  • You do not have an OR Yankauer on continuous wall suction unless you are lucky.
  • Clear the mouth first. Then bag. Then the tube if you have one. Protocol owns catheter size.

Field Rules (Education)

  • Gross first: food, blood, and vomit need a rigid large-bore tip. A 14-Fr whistle-tip will not move a meatball.
  • Short bursts: teaching cue is about 10 seconds, or less than you can hold your own breath. Then oxygenate. AHA ventilation teaching still wants visible chest rise, not a blue patient you suctioned forever.
  • Measure flexible catheters: corner of mouth to earlobe/tragus for oral; for ETT, insert only to just beyond the tube tip. Deep blind plunges cause bradycardia and bleeding.
  • Turn it on and test it when you walk to the patient, not after the first failed bag.

Field Pitfalls

  • Bagging against a pool of vomit instead of rolling/suctioning first.
  • Using the ETT suction catheter as the only tool for a full mouth.
  • Suctioning so long the next problem is hypoxia, not the original mess.

Practice

60-second drill

Partner: (1) steak in the oropharynx, still a pulse; (2) intubated, sudden gurgling in the tube; (3) copious blood, no suction charged. Name the tip and the next breath plan.

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

Street decisions from this lesson only. 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 truck:
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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