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.

1. 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 Lower Airways

4. Upper Airway Anatomy

5. Upper Airway System

6. Lower Airway Anatomy

7. Ventilation & Respiration

8. Alveolar Function

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/sisrm.html
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