Device Performance During Simulated Emergency Infant Oropharyngeal Contamination: Effects of Airway Anatomy and Fluid...

Background: Sudden contamination of the pediatric oropharynx by regurgitated material, emesis, or blood is a time-critical airway emergency. Rapid clearance may be required to restore laryngeal visualization and permit ventilation and tracheal intubation. Comparative data for commonly available suction devices in anatomically constrained infant airways remain limited. We evaluated how airway anatomy and fluid consistency affect the performance of a rigid Yankauer suction tip and a 14 French (Fr) flexible suction catheter. Methods: This pilot simulation study used two complementary models: an anatomically constrained infant airway mannequin and an unconstrained open-container model. Water, whole milk, and plain yogurt (50 mL) represented contaminants of increasing consistency. Both devices were tested at a standardized wall-suction pressure of -200 mmHg, selected as a high-vacuum emergency bench condition rather than as a recommended pressure for routine pediatric suctioning. In the mannequin, suction time, evacuated pharyngeal volume, residual pharyngeal/esophageal volume, and recovered lung volume were measured. In the container model, time to complete evacuation was recorded. Results: In the infant airway mannequin, the Yankauer evacuated greater pharyngeal volumes for all three fluids. Suction time was shorter with the Yankauer for water but did not differ significantly for milk or yogurt. After yogurt contamination, residual pharyngeal/esophageal volume was greater with the Yankauer, while recovered lung volumes did not differ significantly between devices. In the unconstrained model, the Yankauer evacuated water and milk more rapidly and cleared all yogurt samples; the 14 Fr catheter did not completely evacuate yogurt within the five-minute limit in any trial. Conclusions: Under the standardized high-vacuum conditions of this simulation, relative device performance differed between the two experimental models and across fluids of differing consistency. The Yankauer provided greater bulk removal, whereas the flexible catheter left less residual yogurt in the anatomically constrained model. These bench findings do not establish the safety or clinical superiority of either device at recommended pediatric suction pressures and support further evaluation at lower pressures and during simulated laryngoscopy.