So ever since an online collaboration with James Du Canto and others in the FOAMed community, I’ve been refining the SALAD sim trainer
For those not ‘in the know’ the SALAD technique is designed to manage intubation of the trachea in the face of massive airway contamination e.g. haematemesis or regurgitation of stomach contents
Not a common scenario in theatre…but certainly possible on the wards (MET call), in ED or…perhas more commonly…in the prehospital setting
In fact there’s one series of out-of-hospital cardiac arrests in France where airway contamination was present in a THIRD of cases before EMS arrives…and then potentially worsened by attempts to bag-mask ventilate and/or during attempts to intubate.
In the past I’d advocated use of dual suckers…or even placement of a size 9.0 ETT in the oesophagi as a conduit for oesophageal contaminant. But two sources of suction aren’t always available – and the technique means the oropharynx is crowded!
We (Du Canto and others from a worldwide collaborative) have demonstrated the SALAD technique at smacc in Chicago 2015, Dublin 2016 and dasSMACC Berlin 2017. It’s also made its way into the scientific conference of the Difficult Airway society (UK) and numerous airway courses (I teach it on the Critically Ill Airway course at The Alfred)
So I am often asked ‘how to make a SALAD sim’. I’ve made a few now and made a few mistakes – my latest version is one I am happy with – it is compact for air travel, it’s waterproof, it contains all of my kit including power source and it’s robust.
This video is for those who want to make their own