Dr. Patricia S Vandergrift
Novant Health Forsyth Medical Center, USA
Abstract Title:
SALSA, A Spicy Way to Intubate: Utilizing Supraglottic Airway Devices (SAD) for Neonatal Surfactant Delivery
Biography:
Patricia S Vandergrift has been a nurse for 34+ years and NNP for 20+ years. She graduated from University of South Alabama in 2014 with her Doctorate in Nursing Practice. She has been employed at Novant Health- Forsyth Medical Center for the last 20 yr working in the NICU setting during that time. Current role includes bedside NNP, QI coordinator for Women and Children’s Institute, Perinatal & Neonatal Palliative Care Coordinator. Her expertise ranges from Cue Based feedings, Developmental Care, Noise Control, and Kangaroo Care, SIDs prevention, IVH protocol and Emergent Intubations.
Research Interests:
Background: Neonatal endotracheal intubation (ETT) is often traumatic and requires multiple attempts. The SALSA (Surfactant Administration via Laryngeal or Supraglottic Airway) method offers a minimally invasive alternative, potentially reducing airway trauma by utilizing a SAD for surfactant delivery followed by a quick return to non-invasive support.
Goal: This quality improvement (QI) project aimed to increase SALSA usage for eligible neonates (≥800g) from 0% to 25% by December 2026, while reducing the need for repeat surfactant doses within 72 hours.
Methodology: A multidisciplinary team established eligibility criteria, developed audit tools, and provided skill validation for caregivers. Balancing measures included monitoring vital sign variations, gastric residuals, and oropharyngeal trauma.
Results: From October 2024 through December 2025, 45 eligible neonates (14% of total intubations) underwent SALSA, with a 98% success rate (44/45). Only 24% required additional doses. Post-SALSA, neonates with respiratory rates >70 BPM decreased from 60% to 33%, and average FiO2 dropped from 36% to 30%. Oxygen saturation remained stable (94%-97%). Complications were minimal: 7% experienced transient bradycardia, and one procedure was aborted due to device sizing. No airway trauma was documented.
Conclusion: Implementing SALSA proved safe and effective, showing a high success rate and improved clinical stability post-procedure. These outcomes support SALSA as a viable alternative to ETT.
Recommendations: Successful adoption requires multidisciplinary collaboration, leadership buy-in, and continuous Plan-Do-Study-Act (PDSA) cycles for refinement.
