A French national survey - Part 2: What were the conditions of the professional practice of paediatric anaesthesia in 2021?

Context > Before updating of the recommendations on the structural, material and functional organization of paediatric anaesthesia (PA) in France, a national survey explored the current conditions of PA practice and the application of previous guidelines.Methods > An online survey was shared during the second half of 2021 with SFAR and ADARPEF members.Results > The survey was completed by 710 anaesthetists with exclusive paediatric activity (group E) (19%) or mixed adult/child activity (group M) (81%). A medical team was dedicated to PA for 35% of the responders and the presence of an anaesthetic nurse was systematic for 65% of the responders; 38% of them managed one child at a time and 45% simultaneously one child and one adult. In group E, the median ratio (3 anaesthetists for 4 operative rooms) was higher than the desired ratio for 35% of responders. In University hospitals, 27% of responders were also involved in paediatric intensive care and 40% in continuing paediatric care. In group M, children were managed in adult consultation (88%), operating room (73%), in mixed SSPI (50%), in ambulatory (40%) or conventional (33%) adult sector without a dedicated sector. In the M group, the quality of PA activity was considered inadequate by 22% of the responders with insufficient equipment (27%), postoperative monitoring (53%), medical paediatric skills (33%), surgical skills (28%) and anaesthetic nurse skills (22%).Conclusion > Our results pointed caution regarding the organisation of PA activities, in particular the securisation of specific paediatric surgical care pathways and the availability of paediatric equipment.