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Let’s learn about DAS

An interview with Dr McGuire, president of the Difficult Airway Society.
Welcome, Barry. You are an anaesthetist in Dundee, but you’re also the president of the Difficult Airway Society, or DAS. So could you tell us in two words what is DAS all about? The Difficulty Airway Society is a UK organisation. It’s the oldest airway management society in the world I think. Been around for about 25 years. And its purpose is to optimise and promote airway management excellence and safety. So it’s multifactorial, as you said, publications, particularly guidelines. DAS is famed for its guideline production, but also consensus statements in journals. It’s got a website with a lot of educational material, including videos and forum for discussion of various airway topics.
It’s recently promoted a concept of airway leads in the UK so that every NHS hospital in the UK has an airway lead, a designated individual for imparting the information that’s available with regards to safe airway management. And that’s a joint collaborative with the Royal College of Anaesthetists and DAS. How can a clinician who deals with airway management on a day-to-day basis implement some of the recommendations and the guidance from DAS. And also, how can this be implemented at a departmental level? What would be the advice?
So I think you’re right to ask the question with regards to individuals and departments because I think as clinicians, we have a responsibility to practise individual airway management to the best of our ability, but also to disseminate that within a department so there’s some consistency within a department, and there’s mutual learning, and mutual education. So I think the first thing is recognition that airway management safety is integral to what we do. I think historically, Anaesthetists have always thought airway management is what I do. I can’t get any better at it. I’m already skilled.
And now I think we’re recognising that perhaps we can get better, both technically and non-technically from discussing cases, from reading the literature, from holding simulation education, reviewing guidelines, and having a team approach, perhaps involving surgeons, our assistants. So it’s not just one individual practicing in isolation. It’s a team approach with good communication and learning. And now I’m going a little bit off topic, maybe, but DAS started off in the UK, but I know it’s got good relationships with other airway societies abroad. How are you thinking of spreading the word and giving a global flavour to airway management?
I think it’s crucial that we make a great effort to deliver some consistency across the world so that all of us are seeing similar things. And we don’t know if they’ll be seeing exactly the same thing, but consistency in nomenclature, in attitude, in learning based on evidence, Emily. So collect the data as to the best of our ability, whether that’s supraglottic airway use, front of neck access use, and then together, share the messages and hopefully have a consistency in airway management that gives the best to all patients. Thank you. And, Barry, for you, what does airway safety means to you?
To me, it is taking and recognising that airway safety is paramount in an anaesthetic, recognising that it’s not always perfect, recognising that as individuals, we can get better. And to do that, we have to consider the issues, and talk about the issues, and then think about ways ways we can implement improvements. And that has to be multifactorial. That has to be equipment. That has to be personnel, training. That has to be simulation. And that has to be review of cases, airway M&M, Discussion. So it’s a multifactorial approach, a team approach, and just giving it more airtime than perhaps in the past we’ve done. So, Barry, is there anything else you would like to say to our learners today?
I think it would be to maintain your enthusiasm and your passion for airway management. I think there’s always a great challenge to implement guidelines, advice, new equipment, whatever it is. So take those ideas that you hear about in meetings or read about in journals, get local with them. Speak to your colleagues. Educate and disseminate information, and try to truly implement improvements, and not just talk about them. Thank you.

In this video interview, we meet Dr Barry McGuire, current President of the Difficult Airway Society (DAS) and Consultant Anaesthetist at Ninewells Hospital and Medical School. He talks about how we can improve airway management both individually and at a departmental level.

Since its foundation in 1995, DAS has played an important role in improving safety in airway management, advancing education, and promoting research and new techniques [1]. DAS has produced several influential publications, including the 4th National Audit Project (NAP4), with the Royal College of Anaesthetists (RCoA) and a series of guidelines and we will explore these later in the course.

DAS is also active in promoting consistent practice at a global level. In Week 5 we will explore airway management from a Global Perspective.

Is there an Airway Lead in your hospital? Have any of the Difficult Airway Society guidelines been adopted in your department? What are the advantages of standardising policies, guidelines, teaching and equipment?


  1. F. Mir, A. F. McNarry and T. Asai, Role of the Difficult Airway Society in improving airway management. British Journal of Anaesthesia. 121 (1): 12e15 (2018)
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Airway Matters

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