VFlutter
Flight Nurse
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To each their own like you said. If it works for you then keep on with what you're doing I guess. I'm curious though, after flying for a pediatric team for many years why you think this technique would be of benefit in pediatric airways? The last thing I want to do when managing a peds airway with an already limited view, based on limited size of mouth opening it to jam more stuff in there before I get the best view I can obtain.....
To clarify, I approach every airway with the mentality, and set up, that I may need to SALAD or use a bougie. I follow the suction catheter with my C-Mac as i progressively identify structures until i get a view and confirm that the airway is indeed dry then ditch the suction and either pass the tube or the bougie. I only SALAD when it is needed. But if I am using VL then i want to do my best to keep it VL and not contaminate my camera.
As mentioned one of the downsides of SALAD, especially in peds, is it becomes a lot of stuff in the mouth. With the C-Mac it does not really limit the view but does make passing a tube more difficult. I tend to place a bougie, pull the DuCanto, and pass the tube. My last Peds airway was a trauma patient with multiple prior failed attempts and a vomit/blood filled airway with on-going bleeding. SALAD was the only way I could get a view.
I agree with keeping things simple and for many patients the above is overkill however I personally prefer to start will all my cards on the table and practice a standard approach that I can downgrade if not needed. The more you do it the more it becomes muscle memory. For me, I do not feel it distracts or complicates the procedure and works well when you need it.