DAS 2025 Education Package: bridging guidelines and practice

As we all know, clinical practice guidelines only improve safety when they’re translated into routine behaviour. This is particularly true in emergency airway management, where performance is dependent on rehearsal, team behaviours and system design.

The Difficult Airway Society (DAS) 2025 guidelines for unanticipated difficult tracheal intubation in adults build on the influential 2015 publication and introduce important updates in both technical management and human factors. A defining feature of the 2025 guidelines is the accompanying Education Package, developed to support standardised adoption and local ownership of the recommendations across clinical settings. Since launch, the freely accessible online resources have seen wide engagement from clinicians across specialties, professions and healthcare systems, with more than 31,000 downloads in its first two months.

The package has been designed to be adaptable, scalable and quality assured, drawing on principles from implementation and behavioural science. It represents a shift away from reliance on static cognitive aids alone, towards a multimodal, staged educational framework aligned with the realities of airway practice. Its primary aim is to support regular rehearsal of guideline-aligned behaviours, particularly for airway events where cognitive overload and its implications are well recognised. Across all resources, repetition of core concepts in the DAS 2025 guidelines, such as priming, prompting, transitioning, and the critical role of the airway assistant, is intentional, supporting shared mental models and consistent communication within airway teams.

Multimodal Educational Framework

At the foundation of the package are resources designed to support knowledge acquisition and cognitive readiness. Short educational videos (AirClips), webinars and recorded talks (AirTalks) introduce the key themes of the guideline. These resources are intended to support self-directed learning and flipped-classroom approaches. They allow individuals and teams to familiarise themselves with the guidance in advance of practical training, or can be used to consolidate learning.

Recognising the pressure of clinical work, the package includes material designed for brief, practical teaching in the workplace. Bite-sized sessions (AirBites) prompt discussion of both technical and non-technical aspects of airway care, intended for use in theatre, recovery, critical care and emergency departments. They lend themselves to tea-trolley teaching and similar formats that bring teams together, ideally with short, regular encounters without disrupting patient flow.

Team-based cognitive rehearsal and simulation form the heart of the package. Table-top exercises (AirDrills) use a ‘play–pause–rewind’ format to examine team decisions, communication and progression between airway plans. They require little equipment and can be delivered almost anywhere. Structured pause points and debrief encourage reflection and feedback, key components of workplace learning within the RCoA curriculum. AirDrills can be enhanced by Visually Enhanced Mental Simulation (VEMS), using printed representations of patients, monitors and equipment. The simplicity of the method encourages teams to talk through actions, anticipate problems and align expectations. It’s particularly suited to departments with limited access to simulation centres. Importantly, these resources are designed not only for operating theatres but also for critical care and emergency environments, where airway risk is high and consistent approaches are vital. Repeated rehearsal in these formats supports development of the capabilities in practice required for independent airway management and informs entrustment decisions as required for training progression.

High-fidelity scenarios (AirSim) have been developed in collaboration with simulation and human factors experts, and map to the Anaesthetists’ Non-Technical Skills (ANTS) framework. They include options for novice training, aligning with the Initial Assessment of Competency (IAC) requirements, and interprofessional simulation scenarios, which focus more on the ANTS framework. This reinforces professional behaviours expected of airway managers working within multiprofessional teams.

The Education Package also contains practical tools to support local implementation. Downloadable and editable slide decks, infographics such as CICO action cards, and guidance on intubation via supraglottic airway cards are available as additional resources. An updated example checklist for the difficult airway trolley is also available, supporting alignment between standardised education, equipment and clinical systems.

Multiprofessional focus and ongoing evolution

A defining feature of the DAS Education Package is its commitment to interprofessional education. The resources are designed for use by anaesthetists, ODPs, nurses, the wider perioperative team and airway management teams outside theatre settings, reflecting the shared responsibility for airway management. This approach aligns closely with the educational priorities of the RCoA, particularly with its emphasis on patient safety, human factors and multiprofessional working. Further details on curriculum mapping can be found in the table below. The flexibility of the package also supports RCoA’s priorities of accessibility and sustainability, supporting ongoing lifelong learning beyond formal training. Departments can select, adapt and combine resources according to local staffing, equipment and educational infrastructure with the aim of providing equitable access to high-quality airway education across clinical areas.

Importantly, the package is iterative. Departments and multiprofessional teams are encouraged to explore the package, adapt it to local needs, and integrate it into routine training. Users are encouraged to provide feedback, suggestions and examples of local use via the package webpage feedback links. Shared experiences and feedback will be central to its continued evolution, ensuring the resources remain relevant and responsive to clinical practice, ultimately strengthening airway safety across all clinical settings.

The DAS 2025 Education Package can be found here. 

*Mapped to themes within the RCoA 2021 Curriculum.