When intubating the tracheas of patients with gastrointestinal bleeding, vomiting, or copious secretions, standard suction often is inadequate to provide good intubating conditions. As soon as the suction catheter is removed and the endotracheal tube (ETT) is picked up, the liquid reaccumulates, preventing visualization of the airway structures. In these situations, we attach a neonatal meconium aspirator (Neotech Products, Inc., Valencia, CA, USA) to the end of the ETT, then connect the ETT to suction (Fig. 1). By occluding the suction-activation hole with a finger tip, the ETT becomes a large-bore suction catheter. This action allows for continuous removal of the blood/secretions throughout ETT placement and provides a clear view of the glottic structures; the patient’s trachea then is intubated with the same ETT. The trachea then may be suctioned before the meconium aspirator is disconnected.