TissueDB/Simulators/Suction-Assisted Laryngoscopy and Airway Decontamination Simulator (Kumar)

The Suction-Assisted Laryngoscopy and Airway Decontamination (SALAD) simulator is a low-cost adult airway trainer, made by modifying a commercially available Laerdal airway management trainer with locally available parts, for practising SALAD — keeping a continuously soiling airway clear by suction while intubating through it.^[1] A 2-litre hand-held garden spray pump pushes coloured water — red or green, to represent blood or vomitus — up a kink-resistant PVC tube routed through the manikin's stomach and esophagus, flooding the hypopharynx and mouth with a continuous jet; a second, perforated tube drains it back out to a container. The trainee suctions the soiling airway with a wide-bore Yankauer catheter and intubates through it.

1. Remove the lungs of the Laerdal airway management trainer to provide access to the stomach. ⚑ Open for review: the source's Figure 2 (Steps 1 and 5) lifts the lungs out for access and replaces them, while the Discussion states the lungs and stomach were not removed (kept for a natural look and dual-use training). Either way the finished trainer retains its lungs; confirm whether removal is needed for access on a given Laerdal model.
2. Open the distal end of the manikin's stomach by removing its closure clip.

1. Take two 2-metre lengths of clear, kink-resistant, medical-grade PVC tube (6.0 mm inner / 8.5 mm outer diameter; these are supplied with Yankauer suction catheter packs).
2. Cut five to six holes on alternate sides of the first 15 cm of one end of the second tube (Tube-B) to make the drainage tube.
3. Insert the delivery tube (Tube-A) through the distal stomach and push it up the esophagus until the proximal end reaches the upper end of the esophagus.
4. Insert the drainage tube (Tube-B) alongside Tube-A through the same opening; position it so that all of its holes sit inside the stomach.
5. Secure both tubes at the distal stomach with two zip ties to prevent fluid leaking during pressurised delivery.

1. Attach the outer end of the delivery tube to the brass nozzle of the 2-litre hand-held garden spray pump.
2. Fill the pump with simulated airway contaminant — 10 g of red or green food colouring in 2 litres of water, to represent blood or vomitus — and adjust the nozzle so that actuating the piston delivers a continuous jet rather than a sprinkle.

1. Lead the outer end of the drainage tube into the drainage container so the excess contaminant is collected outside the manikin.

1. Reposition the lungs in their original place, restoring the trainer for ordinary airway management training once the SALAD session ends.

For learner-facing setup, operation, and reset between learners (inserting the wide-bore Yankauer suction catheter, suctioning continuously while the contaminant is delivered, and intubating through the soiled airway), refer to the corresponding SELF Module and to Kumar & Kumar 2024.

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