The SALAD Technique

Suction-Assisted Laryngoscopy (with simultaneous) Airway Decontamination

The course duration is 1hr 15min.

2 CPD Points, 2 CEUs.
Accredited by CPDUK and CBRN.

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Jim DuCanto
Dr Jim DuCanto

Dr. James C. DuCanto is an anesthesiologist with 20+ years experience. He is passionate about airway management and minimising the risks of aspiration and its subsequent effects. His passion has led him to develop the SALAD technique, which he is teaching to colleagues around the globe.

Dr. DuCanto currently works at the Advocate Aurora St. Luke’s Medical Centre in Milwaukee, Winsconsin, where he serves as a staff anesthesiologist, Director of the Simulations Centre, and Director of the Anesthesiology rotation for students and residents.

Module 1: Introduction to the SALAD technique
  • Lecture: Introduction to the SALAD Technique
  • Tutorial: Introduction to the SALAD Technique (1)
Module 2: Examining the Core Problems of Managing the Contaminated Airway and the Elements of the SALAD Technique
  • Tutorial: Large-Bore Suction Catheters and Intubation Adjuncts
  • Tutorial: A SALAD-Capable Portable Suction Device
  • Tutorial: Basic Techniques of SALAD
  • Tutorial: Tracheal Tube Delivery in Concert with Suction
Module 3: Methods of Managing the Contaminated Airway During Severe Ongoing Gastrointestinal Bleeding and Emesis
  • Tutorial: Suction-Assisted SGA Insertion and Decontamination
  • Tutorial: Suction to Support Face-Mask Ventilation in BLS
  • Tutorial: Use of a Suction Catheter to Aid Bougie Insertion
  • Tutorial: Using the Free Hand to Adjust Scope Position
  • Tutorial: A Second Assistant & Manual Suction to Assist Decontamination
Module 4: COVID-19 Extras
  • Tutorial: SALAD in the Age of COVID-19
Course Summary

Improving emergency airway management for critically ill patients relies on techniques that enhance first-pass success, as serious complications in this setting occur with repeated attempts. The Suction-Assisted Laryngoscopy (with simultaneous) Airway Decontamination technique (“SALAD technique”) is intended to address the principal issues which cause the failure of basic and advanced airway management on the first attempt. The SALAD technique offers a stepwise method to manage a contaminated and swollen airway by utilizing the rigid suction catheter to remove airway contaminants while simultaneously creating space amidst swollen tissues of the airway in a simple and effective manner. The SALAD technique is applicable to basic airway management as well, as its principals and techniques apply to the use of face mask ventilation, oral airway insertion as well as the insertion and decontamination of supraglottic airways.

Target Audience

Physicians and Nurses in Emergency Medicine and Critical Care Medicine, Paramedics, and Rural GP's

Learning Objectives:

Upon completion of this activity, you should be able to:

  • Understand the principle behind pre-emptive suctioning of the airway
  • Utilize the rigid suction catheter as both a suction device as well as a tool to open the airway for insertion of an oral airway, supraglottic airway, and laryngoscope
  • Describe the strategy of utilizing the rigid suction catheter placed to the left of the laryngoscope to maintain hypopharyngeal decontamination during tracheal intubation ("SALAD park)
  • Understand the strategy of deliberately creating the space for tracheal tube delivery with the index finger of the right hand ("SALAD poke")
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