Large-diameter suction system reduces oropharyngeal evacuation time

Aspiration of vomitus is associated with significant morbidity and mortality. Standard suction equipment may be incapable of rapidly evacuating vomitus from the oropharynx. In this prospective, randomized, controlled bench trial, we compared a large-diameter suction system (5/8-inch open-bore suction tip and 3/4-inch tubing attached to a 1-inch pour spout) with two standard suction systems (small-diameter blunt-nosed and medium-diameter open-bore 1/4-inch suction tips connected to 1/4-inch tubing). Mean evacuation times from the mouth of a volunteer of 90 mL of water, activated charcoal, and Progresso vegetable soup were measured. All systems removed water within 3 s. With vegetable soup, however, both standard suction systems obstructed. Despite additional mechanical scooping with the standard suction wands, the large-diameter system significantly outperformed both standard systems, by 10 s with the soup and 40 s with the charcoal The reduction in oropharyngeal evacuation times of viscous and particulate material may have important clinical implications in the emergency management of the threatened airway.