I think if the paramedic forgot to take the cap off it is a perfect example of a paramedic that forgot the basics. Yes, VentMedic where I was taught my EMT-B we were taught to suction properly. I personally do not see how anybody could miss a red cap. Our suction tip are just in a sterile wrap and not have a red cap. Could it have come from somebody else's other than the ems suction tip?