# Anyone used a SALT Airway on a real patient?



## FFMedic75 (Nov 1, 2009)

We are considering purchasing SALT Airways.  They look like the greatest thing since sliced bread on a manikin.  Anyone actually used one on a patient?  If so why was it used?  Difficult intubation, alternative to laryngoscope, wanted to play with the new toy?  Anyone fail to successfully place the ET Tube with one?  If so what class of airway was the patient, were they later successfully intubated?  Thanks in advance for any input.


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## s4l (Nov 1, 2009)

It looks like a nifty little device.  I'm interested to hear if it works as advertised.


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## allvitals09 (Nov 2, 2009)

Does anyone think that if this device becomes more popular it might go on the the basic curriculum and allow basics to intubate without a separate cert (where available).


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## Meursault (Nov 2, 2009)

allvitals09 said:


> Does anyone think that if this device becomes more popular it might go on the the basic curriculum and allow basics to intubate without a separate cert (where available).



I can only hope not. It's not magic, and without other upgrades, basics won't have the training or equipment to verify tube placement, let alone understand intubation in sufficient depth to make that decision.


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## juxtin1987 (Nov 2, 2009)

CA is pushing towards removing basics anyway and only running Intermediates and Medics, thus allowing anyone to shove tubes and needles into patients. Another way of terming that is, we're going to need a lot more bandages.


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## Mountain Res-Q (Nov 2, 2009)

juxtin1987 said:


> CA is pushing towards removing basics anyway and only running Intermediates and Medics, thus allowing anyone to shove tubes and needles into patients. Another way of terming that is, we're going to need a lot more bandages.



Care to site your source of information on this?  I have to throw out the BS card on this one as there are thousands of EMT-1s in CA (there are no Basics) and there are very few EMT-2s (only 2 counties that I know have protocols for I's).


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## Akulahawk (Nov 2, 2009)

Removing the EMT-1? Doubt it... 

Have I used the SALT device? No. It just looks like someone just re-invented the OPA with some provision to intubate blindly through it... like a poor-man's intubating LMA.


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## juxtin1987 (Nov 2, 2009)

Mountain Res-Q said:


> Care to site your source of information on this?  I have to throw out the BS card on this one as there are thousands of EMT-1s in CA (there are no Basics) and there are very few EMT-2s (only 2 counties that I know have protocols for I's).



The source was verbal from a board member of MVEMS. If implemented, which it's not in the near future by any means, there would be a grace period for EMT-B's to acquire Intermediate training. Probably classes would be offered by employers for the existing Basics. There's no reason a person who's in EMS can't be trained to do ET tubes and IV's without knowing all the ALS of a medic.


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## Mountain Res-Q (Nov 2, 2009)

juxtin1987 said:


> The source was verbal from a board member of MVEMS. If implemented, which it's not in the near future by any means, there would be a grace period for EMT-B's to acquire Intermediate training. Probably classes would be offered by employers for the existing Basics. There's no reason a person who's in EMS can't be trained to do ET tubes and IV's without knowing all the ALS of a medic.



MVEMSA?  As in Mountian Valley EMSA?  The most backwards EMSA I have seen?

Again, BS card!!!  That sounds like someones idea of a good idea that they are presenting as fact.  Unless you can show where such a plan is any stage of development, I am throwing that out as garbage.  Verbal means nothing unkless you can show it to me on paper from an offical source, such as CA EMSA.  (Heck, I have several ideas on where EMS should go structure-wise in CA, but spouting that doesn't carry any more weight than this idea).  There is no way I see this "interesting" concept being adopted in CA; there are too many logistical issues with even trying to implament such a hair brained idea... amd even if it was an idea that is being considered by CA EMSA, then A. where is the world are the writen concepts? and 2. It will never be developed to completion in back-azzwards CA.  In CA, EMT-I do not exist (other than a few dozen or hundread in a few counties) because the idea was, "Why do ALS half-azzed?  Go Medic."

As for your "there's no reason a person who's in EMS can't be trained to do ET tubes and IV's without knowing all the ALS of a medic" idea...  um... careful with ideas like that.  It has nothing to do with training, but with education.  A monkey can perform most ALS procedures with a little training, but it is the education that is important, as it provides you with the understanding of how the procudure works, why it works, when you need to perform the procudure, how to interpret the facts, where to go next, etc...  Ideas like the one you seem to have inherited somwhere actually have no basis in real EMS, just a notion for those without a true grasp on medicine.


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## Mountain Res-Q (Nov 2, 2009)

juxtin1987 said:


> The source was verbal from a board member of MVEMS. If implemented, which it's not in the near future by any means, there would be a grace period for EMT-B's to acquire Intermediate training. Probably classes would be offered by employers for the existing Basics. There's no reason a person who's in EMS can't be trained to do ET tubes and IV's without knowing all the ALS of a medic.



Despite throwing the BS Card out on this one, I would believe that you and/or your source are confused over the information presented in the follow link, which is the analysis of a plan (nation wide, not just in CA) to nationally standardize various EMS levels (FR to EMR / EMT-B to EMT / EMT-I to Advanced EMT / and EMT-P to Paramedic).  While, I doubt that CA will do anything to comply and fall in line (so that we don't have this EMT 1/2/A/B/C/D/I85/I99/IV/P crap we have now), I like it.  As you may notice, the focus is not on more training so that you can do more "cool" procedures, but on education so that if your scope allows you to perform these procudures you will truely be prepared to do so and provide real care for a patient and not just "poke and tube them".  EDUCATION... not TRAINING...

http://nasemso.org/EMSEducationImplementationPlanning/documents/2009NASEMSOGapAnalysisTemplate.pdf

And the EMTLIFE discussion:

http://www.emtlife.com/showthread.php?t=13812


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## FFMedic75 (Nov 2, 2009)

No one device is going to magically allow everyone intubate successfully the first time.  These things are just a new tool.  If they are only useful for intubating class 1 and 2 airways or the average patient, then a laryngoscope works just fine, but if they make it easier to get a patient who is extremely obese or has abnormal facial and neck features intubated rapidly it may be useful.  I just wanted to know if anyone has used one on a patient like that.


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## Shishkabob (Nov 9, 2009)

I was listening to a podcast a couple of weeks ago (EMS Garage I believe?) and they had Bledsoe on it, and he said that he was at TCC with the paramedic students and having them use the SALT airway so they had an untainted source on intubating.  He said it worked with a very high accuracy.


I wanted to be there and try it :sad:


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## JPINFV (Nov 9, 2009)

Mountain Res-Q said:


> In CA, EMT-I do not exist (other than a few dozen or hundread in a few counties) because the idea was, "Why do ALS half-azzed?  Go Medic."



To be fair, that's probably one of the things that California got right. Want to use half-a-medic? Prove that you, in no possible way, can provide full paramedic coverage.


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## Mountain Res-Q (Nov 9, 2009)

JPINFV said:


> To be fair, that's probably one of the things that California got right. Want to use half-a-medic? Prove that you, in no possible way, can provide full paramedic coverage.



To be fair, in California (thanks to the broken system) Medics can in no way provide full paramedic coverage... :glare:


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## JPINFV (Nov 9, 2009)

Mountain Res-Q said:


> To be fair, in California (thanks to the broken system) Medics can in no way provide full paramedic coverage... :glare:



Your talking to someone who fully understands the rape of EMS that the fire department has perpetuated in Orange County. 

...and yes Triemal, I can blame the fire departments fully for the pathetic care provided in OC. After all, except for maybe a handful working the HEMS unit contracted through Mercy Air (Air Methods. I'm not even sure if they use a paramedic), all paramedics in OC are with the fire department.


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## KimberlySkyWalker (Nov 11, 2009)

*SALT Airway*

I have seen the SALT airway used, I am sure Basic EMTs' could use it, and it seems to work well (awesome) in an upright position (entrapment). I do not necessarily think it will ever take the place of intubation, but I do think it is a great option to have in difficult situations (no chord visualization). I don't think anyone should "knock" anything until they have tried it.:B)


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## FFMedic75 (Nov 11, 2009)

KimberlySkyWalker said:


> I have seen the SALT airway used, I am sure Basic EMTs' could use it, and it seems to work well (awesome) in an upright position (entrapment). I do not necessarily think it will ever take the place of intubation, but I do think it is a great option to have in difficult situations (no chord visualization). I don't think anyone should "knock" anything until they have tried it.:B)



So you seen it used in the upright position?  Was the patient average size and build?  Have you ever heard of one being used on a patient who is obese or has other issues that would make traditional intubation difficult?


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## KimberlySkyWalker (Nov 11, 2009)

*reply*

Yes, I have seen it. The main pictures are of a 21 y/o male. average size, I would send you the pics, but that is probably a breach of confidentially. The laryngoscope should be used, but the intubation time is faster. The tongue blade needs to be adjusted.


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## KimberlySkyWalker (Nov 11, 2009)

Oh, I forgot, he was entrapped. Sitting upright. Use the SALT upright with a manikin first, play with it, you will see.


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## Canoeman (Nov 16, 2009)

FF Medic,

I should have gotten into this thread before - I posted in another. Our region is looking into the SALT airway as well. Saw the videos etc. Find no clinical studies etc however. Just interested in more information as well.


Canoeman


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## EMSEdukator (Nov 21, 2009)

Recently attended the conference in Atlanta and asked the rep a question that no one seems to be asking on here.  If you look at the use, mostly seen in manikins, there is no way to stop it from "drifting" to far into the anterior pharyngeal airway.  They stated they were working on this currently. It seems like a great device for tight situations. There is also a new LMA type device out that allows a tube to be passed after its placement.


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## WTEngel (Nov 21, 2009)

I think the thing to remember here is that the SALT is just a tool. The standard for airway management is direct visualization of the trachea, typically by using a laryngoscope. 

All other methods, while they may be effective, are generally not the preferred method.


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## firetender (Nov 21, 2009)

Where can I take a look at this thing?


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## VFFforpeople (Nov 22, 2009)

Mountain Res-Q said:


> Care to site your source of information on this?  I have to throw out the BS card on this one as there are thousands of EMT-1s in CA (there are no Basics) and there are very few EMT-2s (only 2 counties that I know have protocols for I's).



Agreed I am with you..last i heard they were upping EMT-1 and yes NorCal EMS has 8-10 EMT IIs so all North cali from I believe Chico to OR border and coast can run EMT IIs. I know shasta county,siskiyou,trinity, not sure about others I think Lassen as well?

Anyway back to point. No Nor Cal just removed tubes well our county did..anyway from Basics. Agree with MrConspiricy about EMTs not having sufficent training or knowledge about em to do it.


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