From my experience of working on the medical unit, I really tell pts and family that I avoid NT suctioning unless absolutely necessary because it feels terrible and probably increases anxiety, pain, and discomfort much more than they were already coping w/ having the gurgles. Coughing and deep breathing is best w/ yankeur, and I usually stick it pretty far in the back of the throat to stimulate the gag/cough reflex. Depending on your pt's prognosis, it doesn't sound to good, so my guess is to suggest yankeur because pts can even do that on their own and it's definitely not as traumatic for the pt and the family that happens to see you do it.