Street Level Airway Management (SLAM) is a general system of teaching basic and advanced airway management skills that are useful regardless of where emergency airway management occurs.  The system is based on the SLAM Concept, which states: "Most airway techniques used in anesthesiology can be generally applied to a variety of areas where emergency airway management is performed by practitioners outside the operating room and hospital."
 
The SLAM  Emergency & Difficult Airway Flowchart is a comprehensive flowchart and can be used by all groups of practitioners, regardless of their previous experience or time spent practicing airway management.  It was designed to assist in preventing major adverse respiratory events such as inadequate ventilation, unrecognized esophageal intubation, and difficult intubation.  The SLAM Flowchart  incorporates features that make it easy to understand, follow, learn, and teach.  The overall intent is to improve patient safety by providing oxygenation and ventilation above intubation. 

The question as to why another airway algorithm has been developed is justified.  Other major algorithms provide valid schemes for management of the airway but are primarily for particular groups of practitioners (usually hospital-based physicians).  However, difficult airway situations can occur across the entire spectrum of healthcare for any provider including physician, nurse, anesthesiologist, paramedic, or other EMS providers. 
 
The SLAM Flowchart presents clear strategies for enabling the practitioner to effectively deal with a wide range of emergency airway situations occurring in and out of the hospital.
 
The SLAM Flowchart provides:

· practitioners with critical decision-making schemes in emergency airway management.
· clear and comprehensive strategies for prevention, rapid recognition, and treatment of critical airway events, especially those occurring in the pre-hospital and non-operating room hospital environments.
· clinical guidance on: 1) when tracheal intubation is appropriate, 2) when to stop attempting tracheal intubation, and 3) when to undertake rescue ventilation.
· for the use of simple techniques to rescue failed intubation.
· for the use of approved supraglottic airway devices for rescue ventilation.
· evidence-based criteria for selection of adjunctive devices to confirm tracheal intubation.
 
James M. Rich developed the SLAM Airway Conferences based on his SLAM Concept and the SLAM Flowchart.  He is the founder and director of the SLAM Airway Training Institute, a private institute dedicated to patient safety, education and training, and clinical competency in airway management.  Since the inception of the Institute and the SLAM Emergency Airway Conferences in 1999, several thousand people have been trained in emergency airway management.  Each attendee receives didactic and hands-on instruction, followed by a written test and a practical hands-on test.  The success of the conferences can be attributed to their cost effectiveness, their portable "we come to you" approach, and their highly organized format.