SALT - Supraglotic Airway Laryngopharyngeal Tube

AdamGent

Longterm Registered User
I saw this piece of kit on the PPA's EMT-B course last week.

Imagine a single piece, single size, plastic tube with no moving parts that is a basic airway for BLS (compatible with BVM) and for ALS allows for blind intubation with a ridiculously high ( soemthing like 98.9%) success rate even in low light or confined space?

Oh, and it sells for a humble $25.

They say the simple ideas are the best...

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The SALT Airway
 
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Wasn't that accomplished by Igel? EMT-Bs can sink an airway?

A number of supraglotic airways can be used as conduits for tracheal intubation with the aid of fibreoptic observation, but not blind.

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The SALT allows for a high success rate in blind intubation (as long as it is within your skill set blah blah blah...)


NPA, OPA and supraglotic airways such as LMA, iGel and King airway are certainly within the remit of the EMT-B as far as I know.
 
We carry the SALT as a back up, back up, extra tool in the box. We only would use these in a circumstance where we physically can't control an airway (unable to visualize for ET etc, or couldn't cric) IE confined space, small vehicle, helo etc. I have seen the videos and we train on these and on mannequins it is like a 100% success. I can't give a + or a -, since I have not used one in real life, but like I said, it gives another tool for the shed...
 
Please remember that these devices are designed for the operating theatre where the patient is flat on their back, they are seldom moved with this type of airway in situ as any movement has the potential to dislodge the device and allow gastric juices to enter the airway unobserved.

This device is not a method to Intubate the Trachea, it is a method for Supra Glotic airway management.

In an operating theatre or in a situation where a person is being resuscitated prior to additional skilled staff arrive who can intubate the casualty then this device is fine. However, once you start moving the casualty be in in a vehicle or on a stretcher then the supra glotic devices become a hazard as they introduce the potential of an unrecognised airway obstruction due to body fluids introduced as the device is dislodged.

Use with Caution and do not use in a moving vehicle as you will fall into a false sense of security.
 
Phecta, this is a device that was designed to assist in a blind intubation. When the SALT is inserted (as a supraglotic device) it functions as a BLS device as is (bite/block oropharyngeal airway) The center of the SALT acts as a ET guide, the ET tube is slid through the center and is guided into the glotic opening, the device then acts as a bite block. The ET tube is secured via a clamp that goes on the ET tube and the tube is secured via straps. No device (ET tube, King, Combi, Cric etc are really designed to have a lot of movement, hence rechecking LS, dislodgement, ETCO2 etc after every move).
 
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as Paramedics in the UK should never ever undertake Blind Intubation. You should always visualise the Cords and the Trachea.

Therefor one has to wonder why this is being shown on courses in the UK?

just curious as to why it is advocated?
 
as Paramedics in the UK should never ever undertake Blind Intubation. You should always visualise the Cords and the Trachea.

Therefor one has to wonder why this is being shown on courses in the UK?

just curious as to why it is advocated?

Because it's 'sexy'
 
Honestly, because it is like everything else "sexy" it just gives someone an additional tool, bling kit to buy or have or use I assume. Like I said, we have them only as a back up, back up back up...I can't say that I am for or against since I have never used one on a patient, but I am like you, no visualization=bad... Which will leads to another discussion...retrograde intubation with a bougie or guide wire.... no visualization there.
 
The answer to the key point is MONEY.

TPs can convince the unskilled to part with substantial amounts of their wedge by including things on courses, which the attendee shouldn't be undertaking due to their lack of skill set. They can then convince the attendee that they're 'qualified' to carry out such actions.

And what's really outrageous about this particular practice is that the employers buy into it, because the unskilled 'medic' is more employable than a real medic because they're cheeper.
 
TPs can convince the unskilled to part with substantial amounts of their wedge by including things on courses, which the attendee shouldn't be undertaking due to their lack of skill set. They can then convince the attendee that they're 'qualified' to carry out such actions.

Just like teaching IO or IV access. What. Is. The. Point.
 
These devices are used by the US military quiet a lot and as such they normally get passed off to Security Team Medics along with lots of other items such as tourniquets and hemostatic agents. Medic courses in the UK as discussed on here are primarily for combat trauma in the PSC community where medical kit is mostly overlooked by companies so the guys normally have what they have begged or borrowed in theatre. Teaching Supraglottic airway management with these devices is now normal in the TCCC program or combat lifesaver courses and I suppose is naturally moving in to the front line medic courses in the UK. Although I have to agree with other comments, they can become unstable when moving a patient and as such extra care should be taken. when you casevac the patient.
 
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