Background and Goal of Study:
The rapid sequence induction (RSI) of general anesthesia (GA) in full stomach situation is used to avoid aspiration. Excepted in the particular situation of GA performed outside of the operating room, there is no French guidelines about how to perform an RSI, that could lead to wide variability in practices. This survey aimed to collect data about the practice of the RSI in France.
Materials and Methods:
This national electronic survey was conducted between April and June 2016, to anesthesiologists- intensivists, intensivists and emergency physicians of the 32 University Hospitals and Regional Hospitals of France. After approvement, the head of each department diffused an e-mail with a link to an electronic form to all practitioners.
The form included 37 closed anonymous questions. 5 practitioners tested the form before his diffusion and answered it in 5 to 7 minutes.
Results and Discussion:
57 of the 155 heads of department contacted accepted to participate. 2111 practitioners from 26 hospitals should have received the form. 402 (19%) of them have answered. Among the 402 responders 309 (77%) were senior practitioners, 96 (23%) junior; 236 (59%) were anesthesiologists, 26 (6%) intensivists and 140 (35%) emergency physicians.
398/402 (99%) practitioners said to perform RSI. 177/398 (44%) practitioners used the Sellick maneuver (SM) during RSI. 132 of 185 practitioners (71%) thought there was no scientific proof of SM utility, 65 (35%) thought the SM inefficient and 61 (33%) thought the SM increases the risk of difficult airway.
 
The practice of RSI is not homogeneous among French practitioners. Mainly, the practice depends on the practitioner speciality. With little morphinomimetics and SM, French practices are close to German ones, when Americans and British use more SM and morphinomimetics before laryngoscopy.
Conclusion(s):
Actualized guidelines adapted to current practices and specific clinical situations are needed.


07 / Rapid Sequence Induction in France in 2016: a national survey