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In this short video, we are going to have a look at one of the most critical skills learned by any first aider, right up to paramedic and doctor. We are going to look at airway management, and in particular, suction, its benefits, how to do it and all the different equipment that we have to help us with the suction. Suction and airway clearance comes in many different forms, from the basic recovery position to postural drainage, to one use only suction, right through to ambulance crews and their electronic suction in the back of the vehicles. The suction and clearance of the airway are absolutely critical in any situation. If a patient goes unconscious, the first thing that becomes occluded is the airway, whether that is the tongue, the muscle dropping into the back of the throat, often referred to as swallowing the tongue, or whether it is blood, vomit, or anything else that gets into the airway like a sweet or something like that with a child. Unless we get that airway clear and patent, it will not work. So suction or postural drainage, whatever technique we have, whatever equipment we have available, we must make sure that that airway is cleared first. The airway is no good unless it is clear, patent and working.

We have already said how critical suction and airway management is, but we can also make a bad situation a lot worse if we do not use the equipment correctly. What you have got to remember is suction does not only suck out fluids, but it also takes air from the lungs, and that is something we do not want to achieve. So we have got to make sure that we maintain the airway, we use the suction correctly, we do not over-insert the suction catheter itself; we use the quickest technique and the simplest technique first and then we progress on. Remember, whether it is outside with a basic first aider who uses the recovery position, or whether it is in hospital or in the back of an ambulance with an actual automatic suction unit or a powered suction unit, there is a technique and there is a method for using it, and we must follow those rules and regulations. They are there for a reason.

That airway can be very easily damaged; it can swell. You can actually push blockages further down and more importantly, as I said to start with, you can suck oxygen from the lungs. So when suction is complete, we must remember that we have to re-ventilate the lungs. And a rule of thumb is you should only suck as long as you can hold your own breath because when the patient needs to breathe, you need to breathe. And that is a rule of thumb that makes it much easier to figure out your timings for suction. The airway must be clear, but also remember the patient must be able to breathe. We have to get oxygen into the lungs to oxygenate the brain. Critical that we re-oxygenate after suction.