Suction Assisted Laryngoscopy Airway Decontamination UW Madison Mar 2015 from AirwayNautics on Vimeo.
Movie captures the important lessons of a simulation session based upon using a rigid suction catheter (Yankauer and other variant) to decontaminate the airway of a modified Laerdal Difficult Airway Simulator mannequin. The technique described in this simulation is known as the “SALAD” technique–Suction Assisted Laryngoscopy Airway Decontamination.
The central tenant of the SALAD technique is to make the rigid suction catheter the “tent-pole” of airway management–the suction catheter is utilized in all phases of laryngoscopy to facilitate the quick and proper placement of the laryngoscope blade on the first pass attempt, in lieu of older methods such as opening the patient’s mouth with a scissor-type gesture of the right forefinger and thumb. The result is speed and efficiency coupled with the ability to decontaminate the airway during routine and emergency airway management. In this same manner, the SALAD method can facilitate the insertion of Supraglottic Airways as well, including the Laryngeal Tube. Modern suction catheters beyond standard hospital-issued Yankauer suctions are discussed and demonstrated as well as portable suction systems are demonstrated.
Prehospital and Retrieval Medicine - THE PHARM dedicated to the memory of Dr John Hinds 
Nice. Especially like the use of existing OT kit and improvisation of tubing with hardware hose/connectors. Especially like fact is portable, can sim in OT, in ED< on wards, on floor, at roadside, in aircraft etc…
Need to ask young Dr DuCanto – that pump, powered by 12V drill – what are the specs? I have been using an underwater pup powered by battery (bilge pump) concealed within my mannikin, but the speed isn't variable….might need to try the variable speed drill-operated pump.
Back to the fake vomit….
The pump is an inexpensive (10 dollar) electric drill driven pump that has very little technical information available on it other than its maximum flow rate of 2.5 gallons per minute (9.4 liter per minute), which likely assumes a maximum drill speed of 3,000 rpm. The drill I am using is branded “Dewalt” and has a selectable transmission–slow (setting 1) or fast (setting 2), intended for drills and bits that require slower or faster rotational rates. I used the slow setting for the simulation, as the object of the simulation was to investigate a potential “standardized” approach to handling the soiled airway, and not to produce a totally out-of-control situation (that will come later). We did run the pump continuously on a few of the simulations, but not at a dreadful pace.
We have some additional simulation goals in the near future, such as comparing the various SGA’s in this simulator (do the vent channels function in the Supreme for instance?).
We discovered that the ramped position does set the vomit up to flow over and then down the larynx and trachea–gives us something to think about–that result warns us to have suction out and ready to go during airway management for sure. We also want to investigate the use of flexible suction catheter down the tracheal tube before ventilation. Good stuff! Although you’re across the ocean, let’s keep the discussion and collaboration flowing here Tim. Without questions and suggestions from folks such as yourself, we won’t be able to get the really important questions asked, then answered.