Rapid sequence intubations by emergency doctors: we can but are we?

Rapid sequence intubation (RSI) is used by emergency doctors routinely in many parts of the world, but it is unclear how many are using this technique in England and Wales.

To determine, through a telephonic survey, which specialty was performing RSIs.

All emergency departments were telephoned, and senior emergency doctors were asked which specialty provided this service, and whether this was done routinely, often, or could be either specialty.

All 207 departments responded. 3 (1%) departments routinely had emergency doctors perform RSIs, and a further 3 (1%) had anaesthetists performing these routinely. In 33 (15.9%) departments, there were equal chances that it could either specialty. Anaesthetists provided the service routinely in 130 (62.8%) and often in 38 (18.4%) departments.

Although there are emergency doctors performing RSIs, the majority of RSIs are still being performed by anaesthetists. When this is added to the curriculum for the Fellowship of the College of Emergency Medicine from 2008, many departments, seemingly, will not be in a position to provide experience in this area.