Emerg Med J 19:109-113 doi:10.1136/emj.19.2.109
  • Original Article

Rapid sequence induction in the emergency department: a strategy for failure

  1. S D Carley,
  2. C Gwinnutt,
  3. J Butler,
  4. I Sammy,
  5. P Driscoll
  1. Hope Hospital, Salford, UK
  1. Correspondence to:
 Dr S D Carley, Department of Accident and Emergency Medicine, Royal Bolton Hospital, Minerva Lane, Bolton, Lancashire BL4 0JR, UK;
  • Accepted 11 May 2001


Background: Rapid sequence induction (RSI) is increasingly used by emergency physicians in the emergency department. A feared complication of the technique is the inability to intubate and subsequently ventilate the patient. Current drills based on anaesthetic practice may be unsuitable for use in the emergency department.

Objective: To construct a drill for failed adult intubation in the emergency department.

Methods: Literature review and consensus knowledge.

Results: A drill for failed adult intubation in the emergency department is given.

Summary: Failure to intubate following RSI in the emergency department is a feared complication. Practitioners must have a predetermined course of action to cope with this event. The guidelines presented here are tailored for use by the emergency physician.


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