ED Doctors & RSI

RSI delivered by EM clinicians is common place throughout the globe, in the UK however it still seems a contentious topic, with recent data showing only 20% of ED RSIs being performed by EM clinicians.

I was lucky enough to be asked to talk at the ICS SoA 2016 conference on the topic of EM doctors carrying out RSI’s in the UK and this podcast is a copy of that talk.

…..following the talk there were quite a few comments and questions flying round the room and social media. I caught up with Rob to run through the main issues raised

Together I hope these podcasts add some context both to UK practitioners and also to those from other countries, who may not understand what the big deal is all about.



A randomized controlled trial on the effect of educational interventions in promoting airway management skill maintenance.Randomized controlled trial. Kovacs G, et al. Ann Emerg Med. 2000

Acute airway management in the emergency department by non-anesthesiologists. Review article. Kovacs G, et al. Can J Anaesth. 2004

Achieving house staff competence in emergency airway management: results of a teaching program using a computerized patient simulator. Mayo PH, et al. Crit Care Med. 2004

The who, where, and what of rapid sequence intubation: prospective observational study of emergency RSI outside the operating theatre. Reid C, et al. Emerg Med J. 2004

Rapid sequence induction of anaesthesia in UK emergency departments: a national census. Benger J, et al. Emerg Med J. 2011.

Tracheal intubation in an urban emergency department in Scotland: a prospective, observational study of 3738 intubations. Kerslake D, et al. Resuscitation. 2015

Systematic review and meta-analysis of first-pass success rates in emergency department intubation: Creating a benchmark for emergency airway care. Park L, et al. Emerg Med Australas. 2016

Scottish Intensive Care Society: RSI

Difficult Airway Society Guidelines

RCOA Anaesthesia in the Emergency Department Guidelines; Chapter 6.1

RCoA & RCEM; Safe Sedation of Adults in the Emergency Department

John Hinds on RSI at RCEM 2015 Belfast

Draft; AAGBI Guidelines: Safer pre-hospital anaesthesia 2016

AAGBI Pre-hospital Anaesthesia Guideline 2009


  • jamie willson says:

    Absolute Belter!

    I feel impassioned by this issue and glad you’re bringing it up. I think its a crushing indictment of training that we are a ‘global outlyer’ and sadly reflects the difficulty balancing service provision vs training. Thinking positively, I hope this debate can be used a spring board to formalising continued RSI competence beyond ACCS and ensure this is fundamental skill is maintained to enhance trainees, patients and departments.

    • Simon Laing says:

      Thanks Jamie. Having trainees like yourself being so passionate about the topic and the development of the specialty is half of the battle. I’m sure there will be many people looking to continue to develop our national training and service delivery in the right direction.


Leave a Reply

© 2024 The Resus Room