Following our supremely successful DART course, we have responded to our delegates' cries for 'simulation' and have developed the new DART-SIM course. This scenario-based course combines difficult airway management with crisis resource management (human factors) training.

It is aimed at anaesthetists who have ideally already attended the DART course, or a similar airway management course. It is not ideal for novice anaesthetists, but a minimum of 12 months experience is fine. We welcome consultant and SAS doctors on the course.

Course structure

• Revision of the DAS guidelines and the skills learnt on the DART course
• Non-technical skills & human factors lecture
• Five difficult airway scenarios in the high-fidelity simulator which are based around the DART skills and airway related situations
• Each delegate participates in two scenarios as 'lead' or 'help' anaesthetist
• This is team training with 3 ODPs also present, to add to the realism
• The day runs from 9am to 4.30pm.

DART is a one day skills course which will teach you to apply the Difficult Airway Society (DAS) guidelines. There are five workshops which address the guidelines for 'unanticipated difficult intubation in an elective patient' and 'non-obstetric failed rapid sequence induction'. The workshops are:

1. Care and use of fibreoptic endoscopes. Practise with manneqin and trainer box. Nasal anatomy video.
2. Asleep fibreoptic intubation using Berman Airway or LMA with Aintree catheter.
3. Use of intubating LMA (iLMA).
4. Emergency cricothyrotomy - cannula and surgical techniques.
5. Alternative laryngoscopes and Proseal LMA.

Awake fibreoptic intubation training is an extraordinary opportunity to become skilled and confident in a procedure that is uncommonly encountered in training. The course is has developed from the excellent evidenced-based method in Norwich. Delegates attending the course will perform airway endoscopy and intubation on their colleagues, and recieve the same treatment themselves. This has multiple educational advantages:

If this all sounds too much, you can still attend as a non-participating observer. This too, is surprisingly educational. 

The day consists of introductory discussions on nasal anatomy, use of the endoscope and information on airway topicalisation. We then move to the operating theatre with a full complenment of emergency facillities and staff available. Airsim mannequins are provided for 'dry run' practise. We then move on to the clinical procedure which is supervised by anaesthetic consultants and experienced ODP. By the end of the afternoon, each candidate will have:

• Topicalised an airway
• Performed four endoscopies
• Passed one nasal tracheal tube
• Observed the others, and their own airway
• Recieved three endoscopies and had the tube passed 

The course has gone from strength to strength since the pilot in 2008. We pay attention to comments from the candidates and continuously evolve the method to provide optimum comfort and safety. We do not use sedation, which would be less safe and diminish the educational opportunities.

We offer AFOI when there is space available in theatre, which means notice is brief. Email notification of an upcoming course is sent to eligible candidates. We need to prioritise those nearing the end of their training but are also keen for any post-Primary trainees to attend. We also welcome consultants and SAS grade doctors. If you are considering applying then it is worth reading the following paper from our sister course in Norwich, about complications of AFOI:

N. M. Woodall*, R. J. Harwood and G. L. Barker . Complications of awake fibreoptic intubation without sedation in 200 healthy anaesthetists attending a training course. British Journal of Anaesthesia 100 (6): 850–5 (2008)