"You can tell the size of a [wo]man by the size of the thing that makes them mad." - Adlai Stevenson

#RapidSequence

Regardless, the results of this paper demonstrate need for further focused research and consensus of range of best practice for #RapidSequence #RSI
Great work @MZanaesthetist @joanaberger3 @SorbelloMax @CarinHagberg

For those who has experienced gastric aspiration a major learning point & refketion was the need to address gastric emptying before anaesthesia #RapidSequence

Half of trainees replying were confident in their #RapidSequence skills. But only 36% were confident in their ability to assess aspiration risk. What about you?

How many of you have been trained in #gastricultrasound? I haven’t!

There is variation in practice associated with countries income.

For a patient with intestinal obstruction-

Lower income preferences were for supine position with NG insertion & cricoid.
Higher income was head up with less NG insertion & cricoid #RapidSequence

The airway experts said:
1. Anaesthetic departments should have #RapidSequence guidelines (89% of experts)
2. Those who perform #RSI should be trained in #gastricUS (43%)
3. At least 2 team members for RSI with cricoid (50%)
4. Trainee #RSI should always be supervised (93%)

Nearly 40% of anaesthetists had experience of pulmonary aspiration under their care.

Of 10k respondents, what were their preferences in #nasogastrictube #position #cricoid for hypothetical patients? #RapidSequence

Trainees - would you want every #RSI supervised? #RapidSequence

#NAP4 revealed that aspiration of gastric contents was the single most common cause of death related to #airway management. Yet, high quality prospective randomised evidence is difficult to obtain for obvious reasons. #RapidSequence shows significant variation in practice

This huge internet based survey also has input from recognised international airway experts #RapidSequence

It also demonstrates how the Internet & social media can be deployed for large scale global sampling of #TeamAnaesthesia. There are biases, but the results are valuable

This survey of 10k practising anaesthetists worldwide showed considerable variation in practice. How might we agree consensus on #RapidSequence #RSI? Should this be standardised?

Dare I even ask, what’s your RSI recipe? Likely recipes, plural. When was the last time you thio and suxed a patient?! Are you a rocuronium lover (recent twitter controversy not withstanding)? What is the purpose of a #RapidSequence? Huge variation.