Matthew Jensen1, Benjamin Barmaan2, Christine M Orndahl3, Amir Louka4. 1. Virginia Commonwealth University Health Critical Care Transport Network, Richmond, VA. Electronic address: matthew.jensen@vcuhealth.org. 2. Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, VA. 3. Department of Biostatistics, Virginia Commonwealth University, Richmond, VA. 4. Virginia Commonwealth University Health Critical Care Transport Network, Richmond, VA; Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, VA.
Abstract
OBJECTIVE: Suction-assisted laryngoscopy and airway decontamination (SALAD) was created to assist with the decontamination of a massively soiled airway. This study aims to investigate the usefulness of SALAD training to prehospital emergency providers to improve their ability to intubate a massively contaminated airway. METHODS: This was a prospective study conducted as a before and after teaching intervention. Participants were made up of prehospital providers who were present at regularly scheduled training sessions and were asked to intubate a high-fidelity mannequin simulating large-volume emesis before and after SALAD instruction. They were subsequently tested on 3-month skill retention. Twenty subjects participated in all stages of the study and were included in the analysis. RESULTS: The median time to successful intubation for all study participants before instruction was 60.5 seconds (interquartile range [IQR] = 44.0-84.0); post-training was 43.0 seconds (IQR = 38.0-57.5); and at the 3-month follow-up, it was 29.5 seconds (IQR = 24.5-39.0). The greatest improvement was seen on subgroup analysis of the slowest 50th percentile where the median time before instruction was 84.0 seconds (IQR = 68.0-96.0); post-instruction was 41.5 seconds (IQR = 36.0-65.0); and at the 3-month follow-up, it was 29.5 seconds (IQR = 25.0-39.0). CONCLUSION: The implementation of the SALAD technique through a structured educational intervention improved time to intubation and the total number of attempts.
OBJECTIVE: Suction-assisted laryngoscopy and airway decontamination (SALAD) was created to assist with the decontamination of a massively soiled airway. This study aims to investigate the usefulness of SALAD training to prehospital emergency providers to improve their ability to intubate a massively contaminated airway. METHODS: This was a prospective study conducted as a before and after teaching intervention. Participants were made up of prehospital providers who were present at regularly scheduled training sessions and were asked to intubate a high-fidelity mannequin simulating large-volume emesis before and after SALAD instruction. They were subsequently tested on 3-month skill retention. Twenty subjects participated in all stages of the study and were included in the analysis. RESULTS: The median time to successful intubation for all study participants before instruction was 60.5 seconds (interquartile range [IQR] = 44.0-84.0); post-training was 43.0 seconds (IQR = 38.0-57.5); and at the 3-month follow-up, it was 29.5 seconds (IQR = 24.5-39.0). The greatest improvement was seen on subgroup analysis of the slowest 50th percentile where the median time before instruction was 84.0 seconds (IQR = 68.0-96.0); post-instruction was 41.5 seconds (IQR = 36.0-65.0); and at the 3-month follow-up, it was 29.5 seconds (IQR = 25.0-39.0). CONCLUSION: The implementation of the SALAD technique through a structured educational intervention improved time to intubation and the total number of attempts.
Authors: Christopher W Root; Oscar J L Mitchell; Russ Brown; Christopher B Evers; Jess Boyle; Cynthia Griffin; Frances Mae West; Edward Gomm; Edward Miles; Barry McGuire; Anand Swaminathan; Jonathan St George; James M Horowitz; James DuCanto Journal: Resusc Plus Date: 2020-05-21