The SALAD Technique Suction-Assisted Laryngoscopy (with simultaneous) Airway Decontamination (Videos)

Understanding the SALAD Technique for Enhanced Airway Management

The SALAD (Suction-Assisted Laryngoscopy with Airway Decontamination) technique is a revolutionary approach to emergency airway management that addresses the challenges of managing contaminated and swollen airways. By integrating simultaneous suction and airway manipulation, SALAD significantly improves first-pass success rates while minimizing the risk of complications.

Principle of Pre-Emptive Airway Suctioning

SALAD emphasizes the importance of pre-emptive airway suctioning to remove contaminants and secretions that can obstruct the airway. Rigid suction catheters are employed not only for aspiration but also as tools to create space within the airway by suctioning away swollen tissues.

Multifaceted Application of the Rigid Suction Catheter

The rigid suction catheter serves multiple functions in the SALAD technique:

1. Suction Device: It effectively removes airway contaminants, facilitating tracheal tube insertion and improving visualization during laryngoscopy.

2. Airway Opener: By gently guiding the rigid suction catheter around swollen tissues, it creates a clear path for airway devices to be inserted.

Strategic Airway Management with SALAD Park and SALAD Poke

SALAD Park and SALAD Poke are two innovative maneuvers that enhance airway management in challenging situations:

SALAD Park: The rigid suction catheter is strategically placed to the left of the laryngoscope, continuously suctioning hypopharyngeal secretions and minimizing the risk of aspiration during tracheal intubation.

SALAD Poke: The index finger of the right hand is used to deliberately create space for tracheal tube delivery, ensuring a smooth and precise insertion.

Extended Applications in Airway Management

The principles of SALAD can be extended to other airway management scenarios, including:

1. Basic Airway Management: SALAD techniques enhance face mask ventilation, oral airway insertion, and supraglottic airway placement.

2. Severe Gastrointestinal Bleeding and Emesis: SALAD facilitates suction-assisted supraglottic airway insertion and decontamination, minimizing the risk of aspiration.

3. Suction-Assisted Face-Mask Ventilation: SALAD improves ventilation by using a suction catheter to clear secretions and maintain airway patency.

4. Bougie-Assisted Tracheal Intubation: SALAD provides suction support for bougie insertion, enhancing the effectiveness and safety of this technique.

5. Manual Suction with a Second Assistant: An additional assistant can provide manual suction to aid decontamination during airway manipulation.

In conclusion, the SALAD technique provides a comprehensive solution for managing contaminated and swollen airways in emergency settings. By combining pre-emptive suctioning, strategic airway manipulation, and innovative maneuvers, SALAD empowers healthcare professionals to achieve successful airway management with greater ease and safety.