Suction-assisted laryngoscopy and airway decontamination (SALAD) was created to assist with the decontamination of a massively soiled airway. We sit down with flight nurse, researcher, and lead author Matt Jensen to discuss this technique and his most recent Air Medical Journal study aimed at investigating its usefulness in training prehospital emergency providers to improve their ability to intubate a contaminated airway.
Video of Matt’s colleague Will Hicks performing the SALAD technique with the screen split between external and internal views: https://drive.google.com/open?id=1Hln8NJT3q4numobBHigE2JShOxuZqW6A
YouTube video of Du Canto demonstrating SALAD: https://www.youtube.com/watch?v=PztChpfur4g
YouTube video showing the inside-mouth view of the technique: https://www.youtube.com/watch?v=57a39GCvWL8
Matt Jensen is a flight, trauma, and critical care nurse with experience in both Australia and the United States. With a passion for evidence-based, patient-centered care, Matt has a particular interest in resuscitation, quality improvement, and research. The proud father to three boys and prouder husband to a pretty American girl, Matt enjoys living in Virginia as an expatriate with its easier access to chicken wings.
1. Helm M, Hossfeld B, Shafer S, Hoitz J, Lampl L. Factors influencing emergency intubation in the pre-hospital setting − a multicentre study in the German Helicopter Emergency Medical Service. Br J Anaesth. 2006;96(1):67–71.
2. Louka A, Stevenson C, Jones G, Ferguson J. Intubation success after introduction of a quality assurance program using video laryngoscopy. Air Med J. 2018;37:303–305.
3. Benger JR, Kirby K, Black S, et al. Effect of a strategy of a supraglottic airway device vs tracheal intubation during out-of-hospital cardiac arrest on functional outcome: The AIRWAYS-2 randomized clinical trial. JAMA. 2018;320:779–791.
4. Bernard SA, Nguyen V, Cameron P, et al. Prehospital rapid sequence intubation improves functional outcome for patients with severe traumatic brain injury: a randomized controlled trial. Ann Surg. 2010;252:959–965.
5. Delorenzo A, St Clair T, Andrew E, Bernard S, Smith K. Prehospital rapid sequence intubation by intensive care flight paramedics. Prehosp Emerg Care. 2018;22:595–601.
6. Hubble MW, Brown L, Wilfong DA, Hertelendy A, Benner RW, Richards ME. A meta-analysis of prehospital airway control techniques part I: orotracheal and nasotracheal intubation success rates. Prehosp Emerg Care. 2010;14(3):377–401.
7. Lossius H, Røislien J, Lockey DJ. Patient safety in pre-hospital emergency tracheal intubation: a comprehensive meta-analysis of the intubation success rates of EMS providers. Crit Care. 2012;16:R24.
8. Pepe PE, Roppolo LP, Fowler RL. Prehospital endotracheal intubation: elemental or detrimental? Crit Care. 2015;19:121.
9. Wang HE, Schmicker RH, Daya MR, et al. Effect of a strategy of initial laryngeal tube insertion vs endotracheal intubation on 72-hour survival in adults with out-of-hospital cardiac arrest: a randomized clinical trial. JAMA. 2018;320:769–778.
10. Breckwoldt J, Klemstein S, Brunne B, Schnitzer L, Mochmann HC, Arntz HR. Difficult prehospital endotracheal intubation − predisposing factors in a physician based EMS. Resuscitation. 2011;82:1519–1524.
11. Gaither JB, Spaite DW, Stolz U, Ennis J, Mosier J, Sakles JJ. Prevalence of difficult airway predictors in cases of failed prehospital endotracheal intubation. J Emerg Med. 2014;47:294–300.
12. Stockinger ZT,McSwain NE. Prehospital endotracheal intubation for trauma does not improve survival over bag-valve-mask ventilation. J Trauma. 2004;56:531–536.
13. DuCanto J, Serrano K, Thompson R. Novel airway training tool that simulates vomiting: Suction-assisted laryngoscopy assisted decontamination (SALAD) system. West J Emerg Med. 2017;18:117–120.