Initial validation of a modified suction task training system.

Suctioning is a procedure used to remove substances from the nose, mouth, pharynx or trachea, either through a natural orifice (nose or mouth) or artificial tubing (endotracheal tube, tracheostomy tube, nasal or oral airway). Respiratory therapists, paramedics, nurses and physicians use suctioning to promote secretion clearance (pulmonary hygiene) and/or maintain a patent airway. This technique is used in patients along the continuum of care, from acutely ill individuals in the community to chronically ill patients requiring long-term airway support. Controversy remains regarding the optimum technique for this procedure, which is not without its risks to patients (1–4). These risks include, but are not limited to, hypoxia, hypotension, mucosal hemorrhage and airway edema (5,6). Unfortunately, students rarely have the opportunity to practice suctioning copious or bloody secretions from the airways of patients in respiratory distress. Simulated encounters may provide an important opportunity to fill this gap. However, the act of suctioning is frequently overlooked during the training of personnel in airway management and, thus, there is a dearth of simulated suction devices that can reproduce the fidelity of this process. We sought to create and validate a suction task training system that is able to recreate the look and feel of suctioning secretions from an actual patient, with the overarching goal of creating a trainer that was inexpensive and easy to replicate. In the present study, we describe our experience developing and obtaining initial validation of the fidelity of a modified suction task training system. This system includes a Yankauer suction tip, tubing, suction canister and small-diameter end-tidal CO2 sampling tubing (also known as ‘CO2 tubing’) that allows the infusion of simulated oropharyngeal secretions into the system. When modified as described in the present study, it results in a task trainer that has both structural and functional fidelity, offering learners an opportunity to practice appropriate and effective suctioning in patients requiring advanced airway support (7).