Suction-Assisted Laryngoscopy and Airway Decontamination (SALAD) – Schritt für Schritt

Bei komatösen oder reanimationspflichtigen Notfallpatienten ist das Atemwegsmanagement häufig durch im Rachen befindliches Blut oder Sekret deutlich erschwert. Hier kann die Intubation unter kontinuierlicher Absaugung – die sogenannte SALAD-Technik – helfen, auch in diesen Situationen den Atemweg erfolgreich zu sichern und gleichzeitig die Menge an aspiriertem Sekret zu verringern.

• Literatur

• 1 Piepho T, Cavus E, Noppens R. et al. S1-Leitlinie Atemwegsmanagement. Anaesthesist 2015; 64: 859-873
• 2 Burns B, Habig K, Eason H. et al. Difficult intubation factors in prehospital rapid sequence intubation by an Australian Helicopter Emergency Medical Service. Air Med J 2016; 35: 28-32
• 3 Helm M, Hossfeld B, Schäfer S. et al. Factors influencing emergency intubation in the pre-hospital setting – a multicentre study in the German Helicopter Emergency Medical Service. Br J Anaesth 2006; 96: 67-71
• 4 Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med 2001; 344: 665-671
• 5 Cook TM, Woodall N, Harper J. et al. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2: intensive care and emergency departments. Br J Anaesth 2011; 106: 632-642
• 6 Root CW, Mitchell OJL, Brown R. et al. Suction assisted laryngoscopy and airway decontamination (SALAD): a technique for improved emergency airway management. Resusc Plus 2020; 1–2: 100005
• 7 Jensen M, Barmaan B, Orndahl CM. et al. Impact of suction-assisted laryngoscopy and airway decontamination technique on intubation quality metrics in a Helicopter Emergency Medical Service: an educational intervention. Air Med J 2020; 39: 107-110
• 8 Jensen M, Louka A, Barmaan B. Effect of suction assisted laryngoscopy airway decontamination (SALAD) training on intubation quality metrics. Air Med J 2019; 38: 325
• 9 Pilbery R, Teare MD. Soiled airway tracheal intubation and the effectiveness of decontamination by paramedics (SATIATED): a randomised controlled manikin study. Br Paramed J 2019; 4: 14-21
• 10 Lin LW, Huang CC, Ong JR. et al. The suction-assisted laryngoscopy assisted decontamination technique toward successful intubation during massive vomiting simulation: a pilot before-after study. Medicine (Baltimore) 2019; 98: e17898
• 11 Ko S, Wong OF, Wong CHK. et al. A pilot study on using suction-assisted laryngoscopy airway decontamination techniques to assist endotracheal intubation by GlideScope® in a manikin simulating massive hematemesis. Hong Kong J Emerg Med 2021; 28: 305-313
• 12 DuCanto J, Serrano KD, Thompson RJ. Novel airway training tool that simulates vomiting: suction-assisted laryngoscopy assisted decontamination (SALAD) system. West J Emerg Med 2017; 18: 117-120
• 13 Bohn A, Brune M. Notfallnarkose: Aufgaben- und Phasen-Konzept. NOTARZT 2024; 40: 287
• 14 EMCrit. SALAD Technique. Zugriff am 14. Januar 2025 unter: https://emcrit.org/salad/techniques/salad-poke/
• 15 Driver BE, Prekker ME, Klein LR. et al. Effect of use of a bougie vs endotracheal tube and stylet on first-attempt intubation success among patients with difficult airways undergoing emergency intubation: a randomized clinical trial. JAMA 2018; 319: 2179-2189
• 16 Ohchi F, Komasawa N, Mihara R. et al. Evaluation of gum-elastic bougie combined with direct and indirect laryngoscopes in vomitus setting: a randomized simulation trial. Am J Emerg Med 2017; 35: 584-588