Objective: We present a novel airway simulation tool which recreates the dynamic challenges associated with emergency airways. The Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) simulation system trains providers to use suction to manage emesis and bleeding complicating intubation.

 

Methods: A standard difficult airway mannequin head (Nasco, Ft. Atkinson, WI) was modified with hardware store equipment to enable simulation of vomiting or hemorrhage during intubation. A pre- and post-survey was used to assess the effectiveness of the SALAD simulator. A 1-5 Likert scale was utilized to assess confidence in managing the airway of a vomiting patient and comfort with suction techniques before and after the training exercise.

 

Results: Forty learners participated in the simulation, including emergency physicians, anesthesiologists, paramedics, respiratory therapists, and registered nurses. The average Likert score of confidence in managing the airway of a vomiting or hemorrhaging patient pre-session was 3.10±0.49, and post-session 4.13±0.22 (p<0.00001).  The average score of self-perceived skill with suction techniques in the airway scenario pre-session was 3.30±0.43, and post-session 4.03±0.26 (p<0.0005). The average score for usefulness of the session was 4.68±0.15, and the score for realism of the simulator was 4.65±0.17.

 

Conclusion: A training session with the SALAD simulator improved trainee’s confidence in managing the airway of a vomiting or hemorrhaging patient.  We feel the SALAD simulation system recreates the dynamic challenges associated with emergency airways and has the potential to transform airway training.