When tracheal intubation has been unexpectedly difficult, the DAS guidelines advise maintaining oxygenation and inserting a SGA device. If successfully placed, this allows time to ‘stop and think’, with intubation via the SGA using the Aintree Intubation Catheter (AIC) (Cook Critical Care, Bloomington, IN, USA) over a flexible fibrescope, an option to consider at this stage.

The AIC is a 56 cm long hollow tube (4.7 mm inner diameter, 6.5 mm outer diameter) that can be loaded over a flexible