SUCTION

- Minimum: Improvised suction (i.e., syringe + nasopharyngeal airway [NPA]) and patient positioning if not contraindicated
- Better: Manual suction bulb with adapter
- Best: Powered commercial suction with oral tip and in-line endotracheal tube suction adapter

Suction should be available when establishing and maintaining an airway to remove excessive secretions or blood. It is particularly important to utilize suction to facilitate view of the vocal cords during endotracheal intubation. In addition, suction should be available for routine and emergency follow-up care for any intubated patient. Suction may need to be utilized as needed to remove secretions, mucous or blood from the airway. In the event of high airway pressures, suction may be used to remove mucus/mucus plugs or to clear obstructions. In the case of thick secretions, a saline flush of 1-2 mL followed by in-line suctioning of the endotracheal tube may be useful.

NOTE: During in-line suctioning of tubes, the suction should only be applied when withdrawing the catheter and not upon initial insertion.