Improvements to S.A.L.T. Airway System

As emergency medical providers, we know firsthand that effective airway management is an essential skill to learn. Oftentimes when these skills are put to the test we don’t have the luxury of time, a convenient location, or even a clear line of sight. When faced with these circumstances, an alternate airway device can make all the difference in achieving successful intubation quickly and effectively.

One airway device many of us are familiar with is the S.A.L.T. (Supraglottic Airway Laryngopharyngeal Tube) airway system. The one-time use S.A.L.T. II has a unique design that helps users easily align all the airway anatomy, even allowing rescuers to continue CPR during intubation. Some of the new features and their benefits for EMS pros include:

  • A midline indicator that helps keep the device centered during placement to prevent tissue damage.
  • An enhanced epiglottic blade to cradle and lift the epiglottis.
  • An attached proximal collar with tactile ridges for easy insertion, which is especially useful in low light environments. This also serves as a depth indicator ring to allow the rescuer to see that the device has been inserted to the proper depth.
  • An endotracheal tube securing clamp and securing strap which both are used to secure the S.A.L.T. device and the endotracheal tube once it’s been placed properly. This prevents the tube from moving out of position when transporting a patient.
  • Water soluble lubricating gel pack to facilitate both the insertion of the S.A.L.T. device into the oropharynx, as well as the endotracheal tube into the S.A.L.T. device.

Another benefit of the enhanced S.A.L.T. airway system is that it can be successfully placed by emergency medical providers of varying levels; in fact, a study conducted by Bryan Bledsoe, DO, FACEP, FAAEM, a professor at the University of Nevada School of Medicine, found the S.A.L.T. device was successfully placed 96 percent of the time[i] regardless of the level of training.

I know plenty of colleagues who have used S.A.L.T. In speaking with them in advance of this post, one of them shared that he has used the device four times and has been successful every time. Another offered some advice from his own personal experience. He shared, “When inserting S.A.L.T., slightly withdraw the device if met with any resistance and then the endotracheal tube will advance into the trachea without any complications.”

This was a tip he discovered when treating a patient with severe head trauma and one I’m sure many emergency medical professionals will find valuable in helping them succeed when using S.A.L.T.

I’ve been an EMS training officer for a volunteer fire-rescue agency for a number of years and training other emergency medical providers is something that is very important to me, so I was very excited to have the opportunity to educate others on the S.A.L.T. II device. I participated in a training video with the device manufacturer, Ecolab, that walks you through the new features of the device that I mention above, as well as demonstrates how to effectively use the S.A.L.T. airway system.  I encourage you to take a look and provide details about your experience using the S.A.L.T. in the field below.

If you want to learn more about S.A.L.T. visit

Editors note: A representative of Ecolab Healthcare coordinated writing and submission of this guest post after reading a guest review of the previous version of the S.A.L.T. 

About the Author:

Pat Miller has served as a paramedic for 20 years and has been active in both the public and private EMS sectors. He has also served as an EMS training officer for a volunteer fire-rescue agency.

[i] Bledsoe, B.E.; Slattery, D.; Lauver,  R.; Forred, W.; Johnson, L.; Rigo, G.; Can Emergency Medical Services Personnel Effectively Place and Use the S.A.L.T. AIRWAY? Annals of Emergency Medicine. Volume 56, No.3, September 2010.