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Anatomy Review and S.A.L.T.™ OveRview
This document provides an overview and objectives for a training on anatomy of the upper and lower airways, ventilation, respiration, and use of the S.A.L.T.TM device. It describes the S.A.L.T.TM as a single-use oropharyngeal airway that can facilitate blind intubation and reduce accidental extubation. It also lists the standing medical order for use of the S.A.L.T.TM device, which allows its use after two unsuccessful intubation attempts to help guide placement of an endotracheal tube.
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Anatomy Review and S.A.L.T.™ OveRview
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- 2. Objectives Name the major components of the upper and lower airways Describe the functions of the upper and lower airways Describe the process of ventilation Describe the process of respiration Identify the S.A.L.T.™ device Demonstrate use of the S.A.L.T.™ device Explain the SMO for the S.A.L.T.™ device
- 3. Upper and LowerAirways
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- 9. Supraglottic Airway Laryngopharangeal Tube “The S.A.L.T.™ is a unique single patient use oropharyngeal airway which can be utilized to facilitate blind, endotracheal intubation. The S.A.L.T.™ can also be utilized to reduce accidental endotracheal tube extubation.”
- 10. Using the S.A.L.T.™Device
- 11. Standing Medical Order* A. Open Airway 1. Manual maneuvers 2. Clear obstructions using the appropriate techniques/suction 3. If necessary, insert appropriate airway device to maintain the airway (i.e. oropharyngeal, nasopharyngeal, endotrach eal tube, S.A.L.T. ™, Combi-tube/King Airway, cricothyrotomy) *The following SMO is provided as an example only. Check with your Medical Director for the current Airway Management SMO at your service.
- 12. Standing Medical Order 4. Intubate any unconscious patient without a gag reflex a. monitor patient’s pulse oximetry and cardiac rhythm at all times to prevent unrecognized hypoxia b. hyper oxygenate prior to intubation attempt c. if not able to place tube within 30 sec., withdraw, hyper oxygenate, and re-attempt d. verify placement using Ambu tube check device, observing appropriate chest rise, end tidal CO2 monitoring, and auscultation of breath sounds e. orotracheal or nasotracheal intubation as indicated f. secure tube with ET tube holder (pediatric – use tape) g. in the cardiac arrest situation, initial airway management should be completed with manual maneuvers, & simple adjuncts.
- 13. Standing Medical Order 5. After two unsuccessful attempts at intubation by direct laryngoscopy, hyper oxygenate the patient, place S.A.L.T. ™ adjunct, hyper oxygenate, then intubate through the S.A.L.T. ™. The S.A.L.T. ™ is only indicated in patients for whom 6.5mm through 9.0mm ETT is appropriate. 6. Nasotracheal intubation and nasal airways should be avoided in the patient with facial trauma, or suspected basal skull fracture. 7. Extreme caution should be exercised in any patient experiencing significant head injury, or with signs of rising intracranial pressure.
- 14. Standing Medical Order 8. With suspected head injuries, administer Lidocaine 1.5 mg/kg prior to ETT intubation to help prevent rise in ICP. 9. For any patient with a GCS < 8, complete endotracheal intubation 10. Only if necessary, in the unusually difficult intubation, and when the patient can not otherwise be oxygenated by basic life support measures, consider giving Versed (or valium) 5 mg IVP + Morphine Sulfate 2 mg IVP to facilitate intubation per Medication Facilitated Intubation Standing Order.
- 15. Standing Medical Order 11. A Combi-tube/King Airway should be used if attempts at intubation with the S.A.L.T. ™ are unsuccessful. For EMT-I’s, the Combi-tube/King Airway is the advanced airway for utilization. The Combi-tube/King Airway is contraindicated in the following: a. patients under 5 feet in height or over 6’4” in height b. patients who are less than 16 years of age c. patients who weigh less than 90 lbs d. patients who have known esophageal disease e. patients who have ingested caustic substances
- 16. Objectives Review Name the major components of the upper and lower airways Describe the functions of the upper and lower airways Describe the process of ventilation Describe the process of respiration Identify the S.A.L.T.™ device Demonstrate use of the S.A.L.T.™ device Explain the SMO for the S.A.L.T.™ device
- 17. http://www.learning interest.com/wp- content/uploads/ SIS/sisr.html Thank you forcompleting this training program. As part of this research study, please click on the link above to complete the related survey.