Anaesthesia
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It has recently been suggested that recovery rooms should have dedicated anaesthetic cover during working hours to deal with serious life-threatening problems. This audit was undertaken to determine the incidence and severity of airway problems that occurred in the recovery room at a District General Hospital. ⋯ If an airway problem was identified, the patient's notes were examined to document the type of surgery and any predisposing factors which may have contributed. The incidence of airway problems in this study was found to be 2.8%, which was in agreement with previous studies and appears too low to warrant a full-time anaesthetic presence.
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Two hundred and ten obstetric anaesthetists completed a questionnaire assessing how they would perform a rapid sequence induction of anaesthesia for a Caesarean section and their continued management during a failed tracheal intubation. The survey revealed considerable variation in the timing and application of cricoid pressure, the choice and dose of drugs used and the timing of their administration. The management of a difficult intubation also varied. ⋯ There appear to be at least two distinct techniques in current practice, characterised by 'fast' or 'slow' rapid sequence induction. Rapid sequence induction is clearly not a standard technique and debate is necessary to clarify the risks and benefits of its components. In particular, the rapidity of the technique and the application of cricoid pressure may contribute to the increased incidence of difficult tracheal intubation in obstetric anaesthesia.