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Rapid sequence induction: a national survey of practice
1Specialist Registrar and Consultant, Department of Anaesthesia, Royal United Hospital, Combe Park, Bath BA1 3NG, UK.
Anaesthesia
|November 13, 2001
Summary
This survey reveals variations in anaesthetists' rapid sequence induction practices. Many do not adhere to best practices, increasing risks like regurgitation during emergency airway management.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Surgical Safety
Background:
- Rapid sequence induction (RSI) is a critical procedure for emergency airway management.
- Ensuring consistent and evidence-based practices in RSI is vital for patient safety.
- Variations in RSI techniques may impact patient outcomes.
Purpose of the Study:
- To investigate current anaesthetists' practices in rapid sequence induction across the nation.
- To identify adherence to best practices and common variations in RSI.
- To assess the incidence and consequences of difficult intubation and regurgitation during RSI.
Main Methods:
- A national postal survey was conducted among anaesthetists.
- The survey explored drug choices, airway management techniques, and emergency preparedness.
- Data on the use of pre-oxygenation, cricoid pressure, intubation aids, and failed intubation drills were collected.
Main Results:
- All respondents used pre-oxygenation, but techniques varied.
- Thiopental and succinylcholine were common, with propofol and rocuronium used by over a third.
- Regurgitation was frequently observed and led to harm and deaths, while failed intubation drills were uncommon.
Conclusions:
- Significant variations exist in anaesthetists' rapid sequence induction practices.
- Current practices suggest a need for improved adherence to established guidelines.
- Addressing practice variations, particularly concerning regurgitation management and failed intubation drills, is crucial for enhancing patient safety.
