SALSA: Giving SURFACTANT without Intubating (using LMA)

This STEP-by-STEP video will show you how to perform SALSA, a new method of giving surfactant without intubating using an LMA or laryngeal mask airway or device. SALSA or Surfactant Administration Through Laryngeal or Supraglottic Airways, is a new term coined by Dr. Scott Guthrie, Dr. Kari Roberts, and Dr. Prem Fort (ME!) for a method that has been studied and encompasses the use of liquid surfactant through devices that administer surfactant directly into the laryngeal or supraglottic space (no plastic down into the trachea!).
**CHAPTERS**
00:00 SALSA Surfactant administration
00:30 Equipment needed for SALSA
01:04 Preparing the SALSA technique
02:16 Inserting the laryngeal mask device
03:48 Giving surfactant through the laryngeal mask
05:31 Removing the laryngeal mask device
It has been used in preterm infants in small studies, however larger studies still need to be carried out to determine efficacy and safety. This technique, however, can be live-saving in situations where there is no expert present to intubate and mechanically ventilate and the infant would otherwise die without the instillation of surfactant.
SALSA has been studied in small clinical trials and evidence of safety and efficacy is still inconclusive and requires larger trials.
Any use of this technique or method is done so at your own risk and we hold no responsibility or liability.
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[@medicodebebes]

Excelente Técnica Dr Prem y también un muy buen nombre... la pondré en consideración con mis colegas para ponerla en práctica en mi UCIN en Colombia... Muchas Gracias!!! 👏🏼👏🏼👏🏼

[@thenicudoc]

Muchas gracias doctor por sus palabras muy amables. Este metodo todavía so está aprovado y no es estandar. Metanalisis es positivo y en casos extremos o de emergencias, podría salvar vidas...pero importante recalcar que no es un método que utilizamos aquí en EEUU todavía.

[@aklhassan4732]

Thanks for the video and if you please can explain What is the benefit of NCPAP if you are already closing glottis with laryngeal mask?

[@thenicudoc]

Thank you Akl Hassan for this question. You are right, that while the LMA is in place, you could turn off the nasal CPAP as long as you continue PPV through the LMA and then turn ON nasal CPAP when you remove LMA. You just have to remember these steps so many people just leave the nasal CPAP on. Great question!

[@aklhassan4732]

Thanks a lot , very grateful

[@pgrodriguez88]

great video again!!! a question: did you inflate the LMA cuff for the procedure??

[@thenicudoc]

thanks for your question. Yes, you inflate the LMA cuff when I'm position and deflate before removal. Has utilizado una máscara laringea antes?

[@pgrodriguez88]

@@thenicudoc aún no la he usado, I’m a PICU doc, but I’ve been working in a NICU for about a month, and is all new and different. Thank you for your answer! Regards.

[@thenicudoc]

Wow... that's a cool experience. Keep in mind that SALSA is not standard of care in the NICU as of this comment, but more studies need to be done for people to feel comfortable in every day practice. We are trying to do this studies. More to come!

[@pgrodriguez88]

@@thenicudoc Muchas Gracias por su respuesta. By the way, just watched this webinar of COVID-19 you hosted today. Great performance!! A wonderful presentation!! Regards

[@thenicudoc]

@@pgrodriguez88 Thank you....it was a lot of fun.. very smart questions from everyone. Wish I could have answered all of them. Thx again!

[@carlosa.medinacampos8025]

Más fácil que LISA !