Paediatric RSI: Out with the Old, in with the New?

¹Intensive care and anaesthesiology department, Our lady’s hospital for sick children, Crumlin road, Dublin 12
²Intensive care and anaesthesiology department, Temple street hospital, Dublin 2

*Corresponding Author: Rania Haydar, Dromcarra Drive, Jobstown, Tallaght, Dublin 24, E-mail: [email protected].

Received Date: December 12, 2020
Published Date: December 31, 2020
Copyright: Haydar R, et al. ©2020.
Citation: Haydar R, et al. (2020). Paediatric RSI: Out with the old, in with the new?. Mathews J Surgery. (4)1:14.                                                 

ABSTRACT

Background: Rapid sequence induction was first described in adult practice in 1970. Almost 50 years on there is still no international consensus for the direct translation to the paediatric population. In paediatric anaesthesia, RSI is a balance of theoretical risk vs. real world practicalities.

Aim: The primary aim of this study was to assess variation in practice in two longstanding paediatric departments. The secondary aim was to measure the safety profile of said technique used in each department.

Method: A one-page questionnaire was distributed throughout the Intensive care and anaesthesiology departments of the two paediatric hospitals in Dublin regarding two common scenarios. The first a 10-week-old with bronchiolitis needing intubation post feed and the second a two-year-old with a neurovascular injury to the forearm following trauma that requires emergency reduction.

Results: There was a significant difference in the use of standard RSI techniques between the two hospital sites (Table 1).

Conclusion: Practice can vary significantly between two paediatric hospitals despite proximity. But the “classical sequence” of RSI is still performed to this day in large tertiary paediatric centres. This may be because no international consensus exists for RSI in paediatric anaesthesia. Further data is required on modifications to paediatric RSI.