I find it very difficult to reach the trachea. My superior told me that hyperextension of the neck helps and timing suctioning while patients are coughing. However, in my experience, patients are swallowing way more than they are coughing and it's not ideal to wait. I've been reading this pdf file that I've googled and it has great tips to prevent swallowing for conscious clients. However a lot of our patients are disoriented. How do I prevent swallowing? I supposed I can force neck flexion with a pillow but then how to I supress the tongue? Some clients won't even open their mouths? How do I get disoriented people to cough?