TissueDB/Simulators/Suction-Assisted Laryngoscopy and Airway Decontamination Simulator (Kumar)
The Suction-Assisted Laryngoscopy and Airway Decontamination (SALAD) simulator is a low-cost 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.
| Field | Details |
|---|---|
| Features and Basic Operation | Low-cost, reversible modification of a commercial Laerdal airway management trainer, built from locally available equipment (medical-grade PVC tubing, a hand-held garden spray pump, zip ties, food colouring). It reproduces a continuously soiling airway at variable flow for SALAD practice; the simulated contaminant is 10 g of food colouring in 2 litres of water, red or green for blood or vomitus. The lungs are retained, so the trainer still serves ordinary airway training. |
| Current Development Status | Built and tested with learners; learner self-reported confidence only — not validated for skill transfer. |
| Estimated Build Time and Cost | — Not stated in source (described as easy to install). |
| Specialized Tools and Equipment | To run the trainer: a portable suction machine with suction tubing, a wide-bore Yankauer suction catheter, tape to seal its thumb port for continuous suction, an endotracheal tube, and a laryngoscope or video-laryngoscope. The source calls for cutting drainage holes in the second PVC tube but does not name the cutting tool. |
| Version | Version 1 |
| Development Team Contact Information | Rajender Kumar (ORCID 0000-0002-5009-088X; corresponding author, drrbarua@gmail.com) and Rakesh Kumar (ORCID 0000-0002-7732-0112), Department of Critical Care and Department of Anesthesia and Critical Care, Dr Baba Saheb Ambedkar Medical College and Hospital, Rohini, New Delhi, India. |
Tissues
| Tissue | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Oral cavity | 1 (manikin) | Laerdal airway management trainer — life-like oral cavity | — | Access route for the Yankauer suction catheter and laryngoscope into the soiled airway. |
| Hypopharynx | 1 (manikin) | Laerdal airway management trainer — life-like hypopharynx | — | Where the delivered contaminant collects and the trainee practises continuous suctioning. |
| Trachea | 1 (manikin) | Laerdal airway management trainer — life-like laryngeal inlet, with the esophagus behind the trachea | — | The intubation target — the endotracheal tube is placed through the cleared, soiled airway. |
| Stomach | 1 (manikin) | Laerdal airway management trainer stomach, modified with two PVC tubes and two zip ties | — | The contaminant reservoir. The clip at the distal end is removed to admit tube-A, which is pushed up to the upper end of the esophagus, and tube-B, whose drain holes must all sit inside the stomach. Two zip ties then secure both tubes at the distal end and stop fluid leaking during the procedure. Tube-B drains the stomach. The stomach is not removed from the manikin. |
| Esophagus | 1 (manikin) | Laerdal airway management trainer — life-like esophagus, behind the trachea | — | The regurgitation path. The hypopharynx leads into the esophagus, which lies behind the trachea and whose distal end opens into the proximal end of the stomach. Tube-A is pushed up from the distal end of the stomach until it reaches the upper end of the esophagus, so the delivered contaminant emerges there and floods the hypopharynx the trainee suctions against. |
| Blood or vomit | 10 g food colouring per 2 litres of water, per fill | Food colouring in water — red or green, to represent blood or vomitus | — | The coloured fluid is delivered into the hypopharynx and mouth for continuous suctioning and intubation practice. |
Structural Parts
| Part Name | Qty | Material | Cost | Notes |
|---|---|---|---|---|
| Laerdal airway management trainer | 1 (operator-supplied; reusable) | Commercial Laerdal airway management trainer manikin | — | The base manikin the modification is built onto; it stays usable for ordinary airway training once the lungs are replaced. |
| Delivery tube (Tube-A) | 1 length of 2 metres | Clear flexible kink-resistant medical-grade PVC tube, 6.0 mm inner / 8.5 mm outer diameter (supplied with Yankauer suction catheter packs) | — | Carries pressurised contaminant from the spray pump up through the stomach and esophagus to the upper esophagus; its outer end joins the pump nozzle. |
| Drainage tube (Tube-B) | 1 length of 2 metres | Clear flexible kink-resistant medical-grade PVC tube, 6.0 mm inner / 8.5 mm outer diameter, with five to six holes cut on alternate sides of the first 15 cm of one end | — | Drains contaminant out of the stomach to the container; the holed end sits inside the stomach. |
| Zip ties | 2 | Standard cable ties | — | Secure both tubes at the distal stomach so the pressurised contaminant does not leak. |
| Garden spray pump (2-litre) | 1 (reusable) | Hand-held 2-litre garden spray pump with a piston, a brass nozzle, and a pressure-release lever | — | Pressurises and delivers the contaminant as a continuous jet; the brass nozzle joins the delivery tube. |
| Drainage container | 1 (operator-supplied; reusable) | Any container that accepts the drained contaminant | — | Collects the contaminant draining from the manikin. |
Build Instructions
Phase 1: Prepare the manikin substrate
- Remove the lungs of the Laerdal airway management trainer to provide access to the stomach. 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.
- Open the distal end of the manikin's stomach by removing its closure clip.
Phase 2: Make and insert the two PVC tubes
- 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).
- 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.
- 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.
- 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.
- Secure both tubes at the distal stomach with two zip ties to prevent fluid leaking during pressurised delivery.
Phase 3: Connect the contaminant delivery line
- Attach the outer end of the delivery tube to the brass nozzle of the 2-litre hand-held garden spray pump.
- 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. Pressurise the pump by repeatedly pumping the piston. Adjust the nozzle so that pressing the release trigger delivers a continuous jet rather than a sprinkle.
Phase 4: Route the drainage line
- Lead the outer end of the drainage tube into the drainage container so the excess contaminant is collected outside the manikin.
Phase 5: Replace the manikin lungs
- Replace the lungs in their original position before using the assembled trainer.
Use the source’s low-viscosity coloured-water mixture; thicker mixtures can block the spray-pump nozzle, and delivered flow can vary between learners.[1]
For setup and operation, including sealing the Yankauer suction catheter's thumb port with tape for continuous suction, delivering the contaminant, and intubating through the soiled airway, see Kumar & Kumar 2024.
References
- ↑ 1.0 1.1 Kumar R, Kumar R. An Indigenous Suction-assisted Laryngoscopy and Airway Decontamination Simulation System. Indian Journal of Critical Care Medicine 2024;28(7):702–705. DOI: 10.5005/jp-journals-10071-24760. PMID: 38994267. PMC: PMC11234124. License: CC BY-NC 4.0.
| Authors | Arturopelayo |
|---|---|
| License | CC-BY-SA-4.0 |
| Cite as | Arturopelayo (2026). "TissueDB/Simulators/Suction-Assisted Laryngoscopy and Airway Decontamination Simulator (Kumar)". Appropedia. Retrieved September 13, 2026. |