title: Novel Airway Training Tool that Simulates Vomiting: Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) System.
abstract: BACKGROUND
  We present a novel airway simulation tool that recreates the dynamic challenges associated with emergency airways. The Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) simulation system trains providers to use suction to manage emesis and bleeding complicating intubation.
  
  
  METHODS
  We modified a standard difficult-airway mannequin head (Nasco, Ft. Atkinson, WI) with hardware-store equipment to enable simulation of vomiting or hemorrhage during intubation. A pre- and post-survey was used to assess the effectiveness of the SALAD simulator. We used a 1-5 Likert scale to assess confidence in managing the airway of a vomiting patient and comfort with suction techniques before and after the training exercise.
  
  
  RESULTS
  Forty learners participated in the simulation, including emergency physicians, anesthesiologists, paramedics, respiratory therapists, and registered nurses. The average Likert score of confidence in managing the airway of a vomiting or hemorrhaging patient pre-session was 3.10±0.49, and post-session 4.13±0.22. The average score of self-perceived skill with suction techniques in the airway scenario pre-session was 3.30±0.43, and post-session 4.03±0.26. The average score for usefulness of the session was 4.68±0.15, and the score for realism of the simulator was 4.65±0.17.
  
  
  CONCLUSIONS
  A training session with the SALAD simulator improved trainee's confidence in managing the airway of a vomiting or hemorrhaging patient. The SALAD simulation system recreates the dynamic challenges associated with emergency airways and holds promise as an airway training tool.
authors.affiliation: Aurora St. Luke's Medical Center, Department of Anesthesiology, Milwaukee, Wisconsin.
authors.forename: James
authors.initials: J
authors.lastname: DuCanto
authors.affiliation: University of North Carolina, Department of Emergency Medicine, Chapel Hill, North Carolina.
authors.forename: Karen D
authors.initials: KD
authors.lastname: Serrano
authors.affiliation: University of Wisconsin, Department of Emergency Medicine, Madison, Wisconsin.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Thompson
mesh_terms: D002983:Clinical Competence; D003666:Decontamination / Q000379:methods*; D004521:Educational Measurement; D006282:Health Personnel / Q000193:education*; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D007828:Laryngoscopy / Q000193:education* / Q000295:instrumentation*; D008348:Manikins; D013396:Suction / Q000379:methods*; D014839:Vomiting / Q000628:therapy