Anaesthetist Adam Rehak describes and demonstrates VAFI (video-assisted fibre-optic intubation) and FARSI (fibre-optic assisted rapid sequence induction), for the management of difficult and traumatised airways.

The mission of the Project for Universal Management of Airways (PUMA) is to create a single set of airway guidelines that provide consistent guidance for airway practitioners of any discipline, in any country, in any context. Following years of development, these guidelines will be released in six separate papers over the coming months. In this session, one of the authors, Andy Higgs, presents highlights of the project.

David Anderson describes the current state of play with airway management in the prehospital setting. There are important differences between airway management in the prehospital environment and airway management in hospital. Prehospital intubation has been practiced for over 50 years and continues to evolve, with many techniques and procedures devised from prehospital use finding their way into ED and ICU practice. The main indications for prehospital intubation are cardiac arrest and severe TBI. 3 large studies show no evidence to support prehospital intubation in cardiac arrest and this practice should probably be reserved for specific cases. Prehospital RSI for TBI remains controversial as the evidence available to date is conflicting and isn’t high quality. While scene time if often commented on, there is no evidence available prehospital RSI increases time to CT or OR for patients with a severe TBI. There is no evidence that any one craft group is better at intubation than any other. In order to make prehospital airway management as safe as possible, innovations such as checklists, kit dumps and pre-drawn syringes are common. Many prehospital services invest much more heavily in the training and maintenance of airway skills than in-hospital specialties.

David Brewster describes the current state of play with airway management in the critical care setting, including a summary of the INTUBE study and the Safe Airway Society guidelines for airway management in COVID-19 patients.

ENT surgeon Georgie Harris and anaesthetist Drew Heffernan describe how they use high flow nasal oxygen to achieve tubeless airway surgery.

In this not-to-be-missed interactive session our hosts, Adam Rehak and Gerri Khong walk you through the good, the bad and the ugly of human factors in airway management. Using video footage of a highly realistic (tachycardia inducing) simulated airway emergency, the multi-stage case discussion canvases both audience responses and the input of a panel of human factors experts: David Brewster, Brooke Dench, Ben Meadley and Ian Summers, to illustrate that airway management is far more than just a technical skill. Instead, it will become clear that success is equally dependent on careful preparation, coordinated teamwork, precise communication and effective cognitive tools.

Jon Gatward, SAS President, leads the acknowledgement of country and introduces SAS 2022.

This session examines the psychological impact of critical airway incidents and explores processes to support resilience and wellbeing in teams dealing with adverse outcomes.

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A significant proportion of serious adverse airway events occur at extubation. In this session, an expert interprofessional panel emphasises that the timing, location and method of extubation requires careful consideration.

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Trading off competing risks can sometimes lead to “Perfect Plan Paralysis”. There may not be a perfect primary plan. In any case, all techniques have a failure rate. In this session, an expert interprofessional panel emphasises the critical importance of committing to and communicating a complete airway strategy: a coordinated series of plans including sequential contingencies for failure.

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