Variation in rapid sequence induction techniques: current practice in Wales.
A questionnaire survey examining rapid sequence induction techniques was sent to all anaesthetists in Wales. The questionnaire presented five common clinical scenarios: emergency appendicectomy; elective knee arthroscopy with a symptomatic hiatus hernia; elective knee arthroscopy with an asymptomatic hiatus hernia; elective Caesarean section; and emergency laparotomy for bowel obstruction. Completed surveys were received from 421 anaesthetists, a 68% response rate. Rapid sequence induction was chosen by 398/400 respondents (100%) for bowel obstruction, 392/399 (98%) for Caesarean section, 388/408 (95%) for appendicectomy, 328/395 (83%) for symptomatic hiatus hernia but only 98/399 (25%) for asymptomatic hiatus hernia (p < 0.001). Trainees were more likely to use a rapid sequence induction technique than consultants and staff grades for the appendicectomy (p = 0.025), symptomatic hiatus hernia (p = 0.004) and asymptomatic hiatus hernia (p = 0.001) scenarios and were also more likely to use a thiopental-suxamethonium combination for rapid sequence induction (p < 0.001).
Koerber
J P
JP
Queen Elizabeth Hospital, Adelaide, SA, Australia. jason.koerber@internode.on.net
Roberts
G E W
GE
Whitaker
R
R
Thorpe
C M
CM
D000328:Adult; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods; D001062:Appendectomy; D002585:Cesarean Section; D004630:Emergencies; D005260:Female; D019538:Health Care Surveys; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D006993:Hypnotics and Sedatives; D007415:Intestinal Obstruction / Q000601:surgery; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D019148:Neuromuscular Blockade / Q000379:methods*; D011015:Pneumonia, Aspiration / Q000517:prevention & control; D011247:Pregnancy; D011364:Professional Practice / Q000706:statistics & numerical data*; D013874:Thiopental; D014852:Wales
D006993:Hypnotics and Sedatives; D013874:Thiopental