The 2004 Meeting was held in Leicester. Workshops on Wednesday 24th November at the Leicester Tigers Rugby Football Club and the Scientific Meeting on 25th and 26th November in the Walkers Football Stadium.

Thanks to Mary Mushambi, Perihan Ali and Jackie Howarth for all their work organising a highly successful meeting.

Report by Dr Rehana Iqbal and Dr Imogen Davies, Specialist Registrars, John Radcliffe Hospital, Oxford.


The DAS organisers for this year’s meeting impressed us again with their choice of venue. Thankfully for those of us unable to tell the difference between Rugby and Football there were clear signs directing us to the workshops and the main meeting!

The first day was devoted to workshops, a format started in Glasgow and proving to be popular with those of us lucky enough to get places. The organisers did well not to be pressured into accepting more delegates as the group sizes were perfect. We rotated through various stations on different aspects of airway management - it was a great opportunity for experienced faculty members to teach small groups with plenty of time for non – threatening practical teaching. We were impressed with the huge range of equipment collected for us and certainly hoped that here were no airway emergencies in Leicester that day! Having spent most of the morning wondering what a Bullard laryngoscope actually looked like, it was nice to finally see one and have it demonstrated by someone using it on a regular basis. Thank you to Professor Crosby for coming so far to show us! Of particular note was the simulation station with fully interactive models. It was surprising how few of us had been on a formal simulation course.

The first day of the main meeting started with an introduction from Dr Mary Mushambi who, with the help of Dr Perihan Ali, had done a fantastic job organising the event. During the morning, we learnt about the assessment and management of the patient with obstructive sleep apnoea and of the morbidly obese patient. This was followed by the Guest Lecture, a thought provoking presentation by Professor Edward Crosby (University of Ottawa) about our continued reliance on the Macintosh laryngoscope for airway management. He repeated the call for us all to improve our comfort levels with alternative methods. This was reinforced by Dr Popat’s presentation highlighting the lack of structured airway training programmes in the UK.

In the afternoon, we learnt about the airway problems of anaesthetising cows with a residual stomach volume of 120 litres whilst being entertained with some extraordinary slides from Paul Crawford, a vet from Co Antrim.

This was followed by presentations of free papers. The huge number of poster displays and the trade stands had to be squeezed in between the talks during refreshment breaks with prizes awarded the following day. Next was a very informative talk by Dr Weiss from Switzerland about the pros and cons of cuffed endotracheal tubes in children, suggesting that specifically designed cuffed tubes may become the new airway management standard in the future.

The day concluded with the AGM followed by an amazing annual dinner at the National Space Centre where we were treated to a drinks reception in the lobby with the space exhibits, a "space show" and dinner in the main hall. The after dinner speaker was Mary, Queen of Scots in full regalia with some rather scary medical props!

The second day of the meeting started with more poster presentations and free papers. Further talks on fibreoptic training issues followed along with lectures on the medico-legal aspects of difficult airway issues.

In the afternoon we had the surgical perspective with Mr Andrew Moir as chair of a session on percutaneous tracheostomies and cricothyroid airway and jet ventilation for upper airway surgery. These two talks were especially interesting for those of us with no experience of these techniques. The afternoon ended with a lively discussion of various case histories. Dr Chris Frerk presented a fictionalised account of the problems that could arise during difficult airway management in which he showed how easily good management could be misconstrued leading to legal action.

The meeting concluded with high sprits at the prospect of reconvening in Lille in 2005 in a strategically planned weekend. Look forward to seeing you all there!

Group A

Ian Mclaren & Gareth Williams, Consultant Anaesthetists, Leicester Royal Infirmary

Adrian Pearce, Consultant Anaesthetist, Guy’s & St Thomas’s Hospital, London and Viki Mitchell, Consultant Anaesthetist, UCLH, London

Mansukh Popat, Consultant Anaesthetist, John Radcliffe Hospital, Oxford

Professor Ted Crosby, University of Ottawa Hospital, Canada

Justiaan Swanevelder, Consultant Anaesthetist, Glenfield Hospital, Leicester

Elaine Tighe, Consultant Anaesthetist, Leicester Royal Infirmary

Richard Vanner, Consultant Anaesthetist, Gloucestershire Royal Hospital

  1. Percutaneous Tracheostomy
  2. Retrograde Blind & Fibreoptic Assisted
  3. Fibreoptic Intubation Through Intubating LMA (Including Aintree Catheter)
  4. Bullard Laryngoscope
  5. Checking of Double Lumen Tube
  6. Simulator
  7. Emergency Cricothyrotomy with Large Cannula Devices

Group B

Will Russell, Consultant Anaesthetist, Leicester Royal Infirmary

Neil Hawkins, Consultant Anaesthetist, Nottingham City Hospital and Andy Norris, Consultant Anaesthetist, Queens Medical Centre, Nottingham

Chandy Verghese, Consultant Anaesthetist, Royal Berkshire Hospital

Mark Halligan, Consultant Anaesthetist, Liverpool

John Henderson, Consultant Anaesthetist, Western Infirmary, Glasgow

Nick Chesshire, Consultant Anaesthetist, Derby

Alistair MacFie, Consultant Anaesthetist, Western Infirmary, Glasgow

  1. Cannula Cricothyroidotomy & Transtracheal Jet Ventilation
  2. Fibreoptic Intubation
  3. Intubating LMA/Proseal LMA
  4. Bonfils
  5. Straight Blade Laryngoscope
  6. Airway Anaesthesia for Awake Fibreoptic Intubation
  7. Bronchial Blocker

Thursday 25th November

08.30 Registration


09.20 Welcome Dr Mary Mushambi, Leicester Royal Infirmary


Chair Dr Jonathan Tring, Leicester Royal Infirmary


09.30 Pre-operative Assessment and Management of a Patient with Obstructive Sleep Apnoea


Dr Chris Hanning, Leicester General Hospital


10.00 Anaesthetic Management of the Morbidly Obese Patient


Dr Jeremy Collins, Stanford University School of Medicine, USA


10.30 Coffee Break and Exhibition


Chair Dr Perihan Ali, Leicester Royal Infirmary


11.00 Airway Management in Maxillofacial Surgery


Dr John Smith, Selly Oak Hospital, Birmingham


11.30 Guest Lecture


The Way Forward in Airway Management and Training
Professor Ted Crosby, University of Ottawa Hospital, Canada


12.30 Airway Training: The UK perspective


Dr Mansukh Popat, John Radcliffe Infirmary, Oxford




Chair Dr Jonathan Thompson, Leicester Royal Infirmary


14.00 Airway Challenges in Veterinary Practice


Paul Crawford, Co Antrim, Northern Ireland




14.15 The Proseal Laryngeal Mask Airway and the Laryngeal Tube Sonda: A Randomised Cross-over Study J Cranshaw & T Cook


14.27 Airway Management in Patients Presenting for Operative Cervical Spine Stabilisation
C Pahl & J Borremans


14.39 Elective use of Tanstracheal Jet Ventilation in 16 Patients Undergoing Laryngeal Surgery with Severe Airway Compromise and Stridor
C Ferguson, A Patel, G Sandhu, D Howard & P O’Flynn


14.51 Exchange of Tracheal Tube to Laryngeal Mask Airway for Emergence in 116 ENT / Head and Neck Patients
A Patel, C Ferguson, D Enderby, N Randhawa, A Fowler & PM Bailey


15.03 Survey of Experience with the more Advanced Components of the 2004 Difficult Airway Society Guidelines
I Hodzovic, AR Wilkes, P Gatuare, IP Latto


15.15 pm Training for Intubation
RS Cormack


15.30 Tea Break and Exhibition


Chair Dr David Fell, Leicester Royal Infirmary


16.00 Cuffed Endotracheal Tubes in Children: Myths and Facts


Dr Markus Weiss, University Children’s Hospital, Switzerland


16.30 Difficult Airway Society Projects and Next Meeting




16.45 Difficult Airway Society AGM

Day 2

Friday 26 November

 Chair Dr Nisha Kumar/Dr Jonathan Thompson, Leicester Royal Infirmary

09.00 Emergency Surgical Airway Access Simulation Using a Sheep Model (ESAAS)
A Heard, P Eakins
09.12 The Management of Upper Airway Tumours Using the Bonfils Laryngoscope
M Halligan & P Charters
09.30 Poster Presentations Airway Management Skills – A National Audit of New-Start Anaesthetic SHOs
C Whymark, A Moores, AD MacLeod Tracheal Intubation Through the Classic Laryngeal Mask Airway: Impact of Training on Technique
MR Rai, RF Danha, MT Popat A National Out-of-Theatre Airway Training Survey
P Suaris, D Berge, A Pearce Are all Laryngeal Mask Airways Alike?
J Glynn, SM Yentis A Randomised Controlled Comparison of Classic LMATM and Cobra Perilaryngeal AirwayTM
TM Cook, J Cranshaw, J Lowe, K Moaz, J Nolan Distribution of Local Anaesthetic in the Airway – A Comparison of Two Devices
M Tewari, A Patel, P Patel C Ferguson, A Fowler, N Randhawa Two-scope Fibreoptic Self-Intubation
S Scott, A Kapila Initial Anatomic Investigations of the Nasir Laryngeal Airway (NLA) – A Novel Supraglottic Airway without an Inflatable Cuff
RM Levitan, WC Kinkle Comparison of Three Intubating Fibreoptic Stylets in Simulated Difficult Laryngoscopy
FB Ahmed, A Patel, C Ferguson, N Ranhawa, A Fowler Chronic Subglottic Stenosis and a Failed Intubation in a Parturient
JS Gray Failed Extubation – Cause for Concern?
R Bhishma, A Sukumaran Tracheal Ring Fracture and Early Tracheomalacia Following Percutaneous Dilational Tracheostomy
EC Ho, A Kapila, W Colqohoun-Flannery
10.30 Coffee Break and Exhibition
Chair Professor Graham Smith, Leicester Royal Infirmary
11.00 Awake Fibreoptic Intubation: Training Issues in the UK
Dr Nick Woodall, Norfolk and Norwich University Hospital
11.30 Awake Fibreoptic Intubation in the Obstetric Patient
Dr Mansukh Popat, John Radcliffe Infirmary, Oxford
12.00 Risk Management Issues in the Difficult Airway: The MDU perspective
Helen Goodwin, Medical Defence Union
12.30 Medical Legal issues in Airway Management: A Clinician’s View
Professor Alan Aitkenhead, Nottingham
13.00 Lunch and Exhibition
Chair Mr Andrew Moir, Leicester Royal Infirmary
14.00 Percutaneous Tracheostomy: An Overview
Dr John Parker, Leicester Royal Infirmary
14.30 Cricothyroid Airway and Jet Ventilation for Upper Airway Surgery: The Leicester Experience
Dr Will Russell, Leicester Royal Infirmary
15.00 Discussion of Case Scenarios
Chair Dr Gareth Jones, Leicester Royal Infirmary
Dr John Henderson, Western Infirmary Glasgow
Dr Ali Diba, Queen Victoria Hospital, East Grinstead
Dr Chris Frerk, Northampton General Hospital
16.00 Presentation of Prizes
16.30 Tea and Close



Space Centre

Thursday 25 November, 7-12 pm

Conference Dinner

National Space Centre


Dinner was in the National Space Centre.

The evening commenced with a drinks reception in the exhibition area surrounded by space rockets, satellites, capsules and hands-on activities encompassing the latest in audio-visual technology.

The first 168 delegates who applied had the opportunity to see ‘BIG’!, a show in the high-tech domed Space Theatre. The show took you on an amazing journey through space visually revealing the exciting and magical beauty of the universe.