SALAD

SALAD is an acronym for the technique of Suction-Assisted Laparoscopy Airway Decontamination developed by Dr Jim DuCanto, who has created both a training model to give practitioners an opportunity to manage an airway during regurgitation of large volumes of blood or gastric contents, and also a dedicated large-bore suction rigid suction catheter for these instances.

Patients who are vomiting actively should ideally be moved into a lateral, head-down position, but this is not always possible.  Rapid suction clearance of the airway will help reduce aspiration and lung injury, and should be practiced in order to be mastered.  Importantly, it is essential to lead with suction when using a videolaryngoscope.  If not, the camera lens becomes contaminated and therefore useless.  It is helpful to use a VL that can still be used for direct laryngoscopy (with a Macintosh or Miller-like blade) in this situation.

Listen to Dr DuCanto explain the basic technique below.

There are plenty of great resources online, including a SALAD Simulation FaceBook group with videos such as this one.

Open access meducation for all aspects of airway management