Difficult Airway Society Equipment List

Difficult Airway Society

Recommended Equipment for Management of Unanticipated Difficult Intubation
(July 2005)

  1. The List 1 is compiled to facilitate techniques recommended in each airway management plan of the DAS guideline algorithm only. (http://www.das.uk.com).
  2. The list also includes equipment that should be available for routine airway management. The decision to stock these items on the difficult airway trolley as well should be a local one.
  3. Alternative techniques are possible for each of the plans and are mentioned in the full paper (Henderson JJ, Popat MT, Latto IP, Pearce AC. Difficult Airway Society guidelines for management of the unanticipated difficult intubation. Anaesthesia 2004; 59: 675-694). Additional equipment recommended in List 2 will be required if departments choose to include one or more of these techniques.
  4. The guidelines are for unanticipated difficult intubation in adult non-obstetric patients only.
  5. The equipment mentioned in the list should be immediately available in all areas where anaesthesia is administered.
  6. It is recommended that the equipment is stocked in dedicated trolleys. These should be regularly checked and stocked. The exact number and location of each trolley should be determined locally.
  7. All anaesthetists and anaesthetic assistants should be familiar with the contents and location of the trolley.
  8. Training should be provided in the use of equipment selected by each department.
  9. DAS recommends the following to facilitate airway training
    • Consultant Airway Coordinator in each departmentAirway
    • Training Room
    • Dedicated lists for airway training
  10. The list does not include equipment required for management of a patient with an anticipated difficult airway. This is an elective scenario and the choice of equipment will depend on several factors.

LIST 1

Recommended equipment for routine airway management

  • Facemasks
  • Oropharyngeal airways: three sizes
  • Nasopharyngeal airways: three sizes
  • Laryngeal Mask Airways
  • Tracheal tubes in a range of sizes
  • Two working laryngoscope handles
  • Macintosh blades: sizes 3 & 4
  • Tracheal tube introducer ("gum-elastic" bougie)
  • Malleable stylet
  • Magill forceps

Recommended equipment for management of unanticipated difficult intubation

  • DAS guidelines algorithm flowcharts (or modified local version)
  • Equipment list for re stocking
  • At least one alternative blade (e.g. straight, McCoy)
  • Intubating Laryngeal Mask Airway (ILMATM) set
    (size 3, 4, 5 with dedicated tubes and pusher)
  • Tracheal tubes – reinforced and microlaryngeal size 5 & 6mm
  • Flexible fibreoptic laryngoscope (with portable/battery light source)
  • Proseal laryngeal Mask Airway (ProSeal LMATM)
  • Cricothyroid cannula (e.g. Ravussin) with High pressure jet ventilation system (e.g. Manujet) OR
  • Large bore cricothyroid cannula (e.g. Quicktrach)
  • Surgical cricothyroidotomy kit

    (Scalpel with no.20 blade, tracheal hook, 6/7 mm tracheal and tracheostomy tubes)

List 2

Recommended equipment for management of unanticipated difficult intubation

Alternative techniques of proven value - Details in guidelines paper.

  • Bullard type laryngoscope
  • Trachlight
  • Aintree Intubation Catheter
  • Combitube

http://www.das.uk.com/dasequipmentjuly2005.doc

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