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To describe the frequency and nature of premedication practices for neonatal tracheal intubation (TI) in 2011; to identify independent risk factors for the absence of premedication; to compare data with those from 2005 and to confront observed practices with current recommendations. Data concerning TI performed in neonates during the first 14 days of their admission to participating neonatal/pediatric intensive care units were prospectively collected at the bedside. This study was part of the Epidemiology of Procedural Pain in Neonates study (EPIPPAIN 2) conducted in 16 tertiary care units in the region of Paris, France, in 2011. Multivariate analysis was used to identify factors associated with premedication use and multilevel analysis to identify center effect. Results were compared with those of the EPIPPAIN 1 study, conducted in 2005 with a similar design, and to a current guidance for the clinician for this procedure. One hundred and twenty‐one intubations carried out in 121 patients were analyzed. The specific premedication rate was 47% and drugs used included mainly propofol (26%), sufentanil (24%), and ketamine (12%). Three factors were associated with the use of a specific premedication: nonemergent TI (Odds ratio (OR) [95% CI]: 5.3 [1.49‐20.80]), existence of a specific written protocol in the ward (OR [95% CI]:4.80 [2.12‐11.57]), and the absence of a nonspecific concurrent analgesia infusion before TI (OR [95% CI]: 3.41 [1.46‐8.45]). No center effect was observed. The specific premedication rate was lower than the 56% rate observed in 2005. The drugs used were more homogenous and consistent with the current recommendations than in 2005, especially in centers with a specific written protocol. Premedication use prior to neonatal TI was low, even for nonemergent procedures. Scientific consensus, implementation of international or national recommendations, and local written protocols are urgently needed to improve premedication practices for neonatal intubation.

Une enquête menée auprès des réanimations néonatales franciliennes en janvier 2016 a montré que les équipes médicales et soignantes s’étaient bien approprié les pratiques imposées par l’évolution législative du début des années 2000. Une autre préoccupation était de savoir quelles modifications étaient attendues par les professionnels dans deux domaines : la tenue des réunions collégiales (RC) et l’implication des parents dans la prise de décision. Matériel et méthodes  : L’enquête a été réalisée auprès de l’ensemble des professionnels impliqués autour du nouveau-né hospitalisé, dans tous les services de réanimation néonatale de la région parisienne, sur la période du 1er au 31 janvier 2016. Elle a été menée à partir d’un questionnaire de type fermé, élaboré par un groupe pluriprofessionnel après revue de la littérature. Il était divisé en trois grandes parties. La première portait sur l’analyse des pratiques recommandées par la loi, la deuxième, au centre de ce travail, interrogeait les professionnels sur ce qui, selon eux, était à modifier dans le texte de loi afin de faire évoluer les pratiques pour les améliorer. La troisième partie du questionnaire cherchait à établir des profils sociologiques et professionnels. Résultats  : Six cent soixante-dix questionnaires issus de 14 centres ont été analysés. Le taux moyen de participation était de 55 % pour les médecins (personnel médical [PM]) et de 39 % pour le personnel non médical (PNM). RC  : la demande de RC pouvait venir d’autres professionnels que le seul médecin référent (90 % des PM et 94 % des PNM), mais aussi des parents (respectivement 67 et 61 %). La demande devait surtout être adressée au médecin référent (84 et 82 %). Participation active des parents à la décision  : 25 % des PM et 19 % des PNM estimaient que les parents ne devaient jamais participer activement à la décision. La crainte d’une culpabilisation des parents était l’argument majoritaire. Les autres réponses se répartissaient entre « parfois » et « systématiquement ». Des différences sensibles existaient entre les catégories professionnelles. Conclusion  : Notre étude illustre l’évolution de la pensée médicosoignante dans les services franciliens de réanimation néonatale. Après avoir compris les impératifs de la réflexion sur la démarche palliative et le respect à apporter à ses obligations formelles, les personnels médicaux et non médicaux imaginent une évolution possible de ces procédures, accordant une place nouvelle aux différents acteurs, à commencer par les parents de l’enfant. Introduction : A survey conducted in January 2016 in the neonatal intensive care units of Île-de-France showed that medical and non-medical professionals had adapted their practices to the evolution of the law at the beginning of 2000. Another concern was to assess the modifications expected by the professionals in two areas: the setting of the multidisciplinary meeting (MM) and the place dedicated to parents in the decision-making process. Material and methods : All the professionals who have contact with the neonates were questioned, in all the intensive care units of Île-de-France, between January 1 and January 31, 2016. The survey was based on a questionnaire prepared by an informal multidisciplinary group, after a review of the literature. All the questions were of the closed type. The questionnaire was divided into three parts: the first dealt with the analysis of the practices required by law; the second part, which is at the center of this study, listed the practices likely to evolve according to the opinion of the personnel surveyed. Finally, the third part gathered demographic and professional information. Results : 692 questionnaires from 14 centres were analysed. Mean participation rate was 55 % for medical personnel (MP) and 39 % for non-medical personnel (NMP). Multidisciplinary meeting (MM) : The setting of a MM could be initiated by any professional other than the referring doctor (according to 90 % of MP and 94 % of NMP), and also by the parents (67 and 61 %, respectively). Still, the request must go through the referring doctor (84 and 82 %). Place of the parents in the decision process : 25 % of MP and 19 % of NMP thought that parents should never actively participate in decision-making. Fear of parental guilt was the main reason. Other answers were divided into “sometimes” and “systematically”. There was significant divergence of opinions between professional categories. Conclusion : Our study illustrates the evolution of the medical and non-medical professionals’ opinion regarding palliative care in the neonatal intensive care units of Île-de-France. Although they all thoroughly understood the importance of a reflexion about palliative approach, and the respect that should be conferred to its formal requirements, medical and non-medical personnel believe that an evolution of their practice is possible, especially to grant a new place to the different actors, starting with the parents of the child.