User:Mr. Ibrahem/Suction assisted laryngoscopy airway decontamination

Suction assisted laryngoscopy and airway decontamination (SALAD) technique is an approach to managing an airway full of vomit, blood, or other debris. This may occur due to vomiting, injury, or upper gastrointestinal bleeding. It is used during laryngoscopy and endotracheal intubation.

The procedure uses a large bore suction catheter, such as a Ducanto suction, instead of the traditional Yankauer suction. Efforts begin by using the right hand to suction down to the base of the tongue, with the laryngoscope following behind. This keeps the camera clean when a video laryngoscope is used. Down to the vocal cords is than suctioned and the suction switched to the left of the mouth and placed into the esophagus. The endotracheal tube can than be placed with the right hand.

The endotracheal tube may be suctioned before ventilation. The technique can also be performed by placing the suction through the vocal cords, removing the suction tubing, placing a bougie through the suction, removing the suction, and placing an endotracheal tube over the bougie into the airway. One theoretical concern is that the technique may remove air from the throat and thus from the lungs.

The technique was described in 2016 by Jim DuCanto. Mannequins, which allow practice of the technique, can be made or purchased. The Ducanto suction costs about 3 USD, while a Yankauer costs about 1.70 USD as of 2023.