Training Airway Decontamination: the Flip Side of Ventilation Centered Airway Approach

SALAD 1In airway management, oxygenation and ventilation are the overriding priorities and fluids in the airway must be avoided and managed at all costs.

It’s not about plastic in the trachea

– Rich Levitan (@airwaycam)

Overwhelming airway fluids can quickly result in aspiration and hypoxia as well as render ineffective any of the following: the ability to ventilate by mask or extraglottic airways, apneic oxygenation, direct and indirect/video laryngoscopy or flexible and stylet based fiberoptic and videoscopic means of intubation. Massive hematemesis, regurgitation, hemoptysis and airway hemorrhage are examples of such difficult airways.

Jim DuCanto’s vomiting simulator is a way to help clinicians and teams train to deal with this situation. In addition it adds a heightened realism and sense of urgency to simulated airway management.  Participants have noted how this is the first time that they have been stressed in airway simulation similar to real life practice. Anesthesiology News has a great summary of this.

Some important concepts include the technique of Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) as well as team work particularly when video laryngoscopy makes multiple operators be able to assist in the airway management in doing Team Intubation [future link to future post to go here].

Look for a “VomiQuin” coming to a venue near you soon or build one of your own. AirwayNautics will post instructions soon. Stay tuned.

SALAD simulation setup

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