When patients die during or after an aspiration event, it’s often because of the exposure to airway contaminants, not hypoxia. The risk of death increases with the volume of fluid inhaled. This is why diligent, intelligent suction can prove life-saving, especially in someone with limited mobility who is actively aspirating or vomiting. The right suction device quickly clears airway obstructions with a high flow rate and powerful suction.
The SALAD technique requires the use of a quality suction machine that can provide continuous suction at a reliable flow rate. For help purchasing your next suction device, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.
But the right device alone isn’t enough. Technique is everything. A novel technique pioneered by anesthesiologist Jim DuCanto is already saving lives. It is suction-assisted laryngoscopy and airway decontamination (SALAD), decreasing morbidity and mortality. Here are five reasons to use this technique to clear an airway obstruction.
The technique is simple, but like all airway management protocols, it requires practice. See a brief overview of the technique.
Aspiration events can happen at a moment’s notice and may occur in the field, the hospital, or the midst of a massive casualty event. Remembering complex airway obstruction management techniques is not easy in high-stress scenarios, but everyone can remember “vomit SALAD.”
Hypoxia due to choking is just the immediate risk of airway obstruction. Aspiration often involves contaminants in people who are already sick. This presents a significant risk of infection, airway injury, pneumonia, inflammation, and death.
Continuous suction using the SALAD method greatly reduces the risk of serious complications. Particularly in elderly and immunocompromised populations, this can be life-saving.
SALAD requires a rigid suction catheter but can be used with a wide range of suction machines. The SSCOR DuCanto catheter, named for the developer of the SALAD technique, is an ideal choice. It’s also compatible with an array of suction machines, which makes it a viable option for all EMS departments, rescue agencies, and hospitals.
Aspiration events can be chaotic. Family members may panic. The patient may be uncooperative or terrified. And the event that precipitated the aspiration may need to be clarified.
Practicing aspiration prevention and management techniques is critical to their success. Drills work best in realistic simulations, and SALAD is easy to simulate. A 2017 study found that a simple modification to a difficult-airway mannequin head could make it easy to simulate aspiration and master the SALAD technique.
Airway management isn’t something providers can learn from textbooks alone. They must be able to practice—and the more practice, the better. Easy simulations may ultimately produce better outcomes.
Editor's Note: This blog was originally published in August, 2018. It has been re-published with additional up to date content.