[French national survey on difficult intubation in intensive care units]. / Enquête nationale sur l'intubation difficile dans les services de réanimation français.

OBJECTIVES: Assessing the theoretical knowledge, practical experience of French intensivists, and their compliance with French Anesthesiology and Critical Care Society's difficult airway algorithms of the expert's SFAR conference of 2006. STUDY DESIGN: Prospective and descriptive national survey. MATERIAL AND METHODS: An anonymous questionnaire with 40 questions was emailed to physicians working in intensive care units in France. RESULTS: Five hundred and eight intensivists answered the survey. Ninety-seven percent of physicians reported having a portable storage unit for difficult intubation. As for practical experience, 421 physicians (83 %) have set up less than 10 laryngeal mask airway, 257 (51 %) have performed less than 10 intubations under fibroscopy and 269 (53 %) have never performed a cricothyroidotomy on mannequin, and 331 (65 %) on a patient. In case of emergency intubation, 29 % of them do not use a rapid sequence induction. Three hundred physicians (59 %) use capnography as monitoring of the endotracheal position. Two hundred and nine (42 %) consider they have not been trained to difficult intubation and 443 (87 %) would like to participate in high fidelity simulations mannequin. CONCLUSIONS: National airway management algorithm was insufficiently followed. Alternative techniques do not seem to be mastered by all physicians. French intensivists expect more training on difficult intubation, including high fidelity simulation.

[Life-saving cricothyrotomy before surgical tracheotomy: two cases]. / Cricothyroïdotomie de sauvetage avant trachéotomie chirurgicale: à propos de deux cas.

The two current cases reported present the situation of "can't intubate can't ventilate" patients with life-saving cricothyrotomy before surgical tracheotomy. These situations emphasize the necessity for clinicians to master difficult intubation and oxygenation algorithms and all available alternative techniques.

[Difficult airway management: assessment of knowledge and experience in anaesthesiology residents]. / Intubation difficile : évaluation des connaissances et de l'expérience des internes en anesthésie-réanimation.

OBJECTIVES: Assessment of knowledge and experience in anaesthesiology residents on alternative techniques for difficult airway management. METHOD: Descriptive study using an anonymous electronic questionnaire, with 20 multiple-choice questions of 59 4th- and 5th-year residents in anaesthesiology of Amiens, Rouen and Caen University Hospitals (France). RESULTS: Fourty-three (73%) answered to the questionnaire. Thirteen residents (30%) admitted to know last expert conference of the French Anaesthesiology Society partially, 19 (44%) didn't train on mannequin or simulator. Twelve residents (28%) admitted to be insufficient trained to set up a Fastrach in an emergency context, and 39 (91%) to set up a transtracheal oxygenation technique. The rates of residents reaching the educational objectives on patients were 4% for the Fastrach, 21% for fiberoptic intubation, 12% for cricothyroidotomy. CONCLUSION: Four years after the expert conference of the French Anaesthesiology Society, the educational objectives are not achieved during the resident training, both on mannequins or patients.