| Taryle DAet al, 1979,USA | 43 intubations in emergency department | Prospective observational study | Grade intubating | EM = 23/A = 20 | Observational study, small numbers; no comparison of specific complications or attempts by specialty; numbers do not add up |
| Complications by specialty (prolonged attempt/aspiration/mainstem bronchus/pneumothorax) | EM = 20/23 v A = 14/23 (p = NS) |
| Dufour DGet al, 1995,Canada | 219 RSIs, including children done in emergency department by emergency physicians | Retrospective observational study | Complications: | | Observational study; no comparison by grade; no other specialty involved with which to compare; no mention of attempts made |
| Hypotension | 24 (10.96%) |
| Aspiration | 3 (1.37%) |
| Bradycardia | 3 (1.37%) |
| Bigeminy | 2 (0.91%) |
| (no failed intubations) |
| Sakles JCet al, 1997,USA | 610 intubations, including children, 515 (89.9%) had RSIs | Prospective observational study | Intubations by specialty | EM = 569 (93.3%)/A = 18 (3%)/Other = 23 (3.8%) | Observational study; no mention of attempts made; no comparison by specialty of success or complications |
| Intubation by grade: | |
| EMR-1 (yr 1) | 15 (2.6%) |
| EMR-2 (yr 2) | 101 (17.8%) |
| EMR-3 (yr 3) | 418 (73.5%) |
| Specialists | 35 (6.2%) |
| Complications: | |
| Cardiac arrest | 3 (0.5%) |
| Dental trauma | 3 (0.5%) |
| Desaturation | 20 (3.3%) |
| Hypotension | 3 (0.5%) |
| Mainstem intubation | 18 (3%) |
| Pneumothorax | |
| Vomiting | 10 (1.6%) |
| Total | 57 (9.3%) |
| Omert Let al, 2001,USA | 200 trauma intubations, 101 anaesthetics in charge (A), 99 emergency medicine in charge (EM) | Prospective observational study | Demographics | A = higher GCS and RTS p<0.001) | Observational study, no power study; many of the A group intubations were actually carried out by EM residents but no record of numbers; small numbers (*figures confusing for EM staff v EM residents (∼SHO) “EM staff then intubated 6/7 that the EM residents failed”; anaesthetists intubated 6 of the EM group) |
| Intubation success within 3 attempts | A = 98%/EM = 87.9%* |
| First attempt | A = 77.2%/EM = 73.7% |
| Complication rates (%): | A/EM |
| Hypoxia | 14.9/18.2 |
| Aspiration | 5/0.1 |
| Mainstem intubation | 5.9/2 |
| Bradycardia | 2/3 |
| Oesophageal intubation | 7.9/6.7 |
| Dental trauma | 0/2 |
| Surgical airway | 2/0 |
| Total (no fatalities) | 37.6/33.3 |
| Butler JMet al, 2001,UK | 60 RSIs in A&E, 4 aged under 10 | Prospective observational study | Specialty of decision maker | A = 16 (26%)/EM = 44 (73%) | Observational study; no power study; small numbers; no comparison of complications by group |
| Specialty of RSI practitioner | A = 35 (58%)/EM = 16 (26%) |
| Complications: 3 cases = A,3 unrecorded | |
| Desaturation | 2 |
| Hypotension | 3 |
| Cardiac arrest | 1 |
| Mean speed to RSI | A = 5:42min/EM = 3:52min (p = 0.17) |
| RSI practitioner arrival within 5 min | A = 51%/EM = 62% |
| Tam AYet al, 2001,Hong Kong | 214 patients requiring intubation in the emergency department (87 in cardiac arrest) including 5 children | Prospective observational study | Success rate: | | Observational study; no power study; no direct comparison between specialties; included paediatric patients; also included non-RSI cardiac arrest patients; small numbers |
| Emergency physicians | 207/214 (97%) 90% on first attempt |
| Anaesthetists (after failed by EM) | 7/214 (3.3%) |
| RSI complications (none fatal): | |
| Detected oesophageal intubation | 8/66 (12%) |
| Dental trauma | |
| Soft tissue injury | 6/66 (9%) |
| Bronchial intubation | 1/66 (1.5%) |
| Desaturation <90%, | 2/66 (3%) |
| Hypotension <90 mmHg | 2/66 (3%) |
| Arrhythmia | 1/66 (1.5%) |
| Wong Eet al, 2003,Singapore | 142 trauma cases | Retrospective observational study | Number of attempts (10 not attempted) | 113/132 (85.6%) first attempt | Retrospective observational study; no direct comparison between specialties; small numbers |
| 129 (97.7%) successful |
| Anaesthetist called (potentially difficult airway) | 13 (9.2%) |
| Complications: | |
| Nil | 109 (76.8%) |
| Hypotension | 27 (19%) |
| Other | 6 (4.2%) |
| Wong Eet al, 2003,Southeast Asia | 1068 emergency department patients requiring advanced airway management (including cardiac arrests) | Prospective observational study | Specialty v success rate, anaesthetist (A) 16, emergency physician (EP)(equivalent SpR grade or above) 658, medical officer (MO) 392 | | Observational study; no power study; no breakdown of complications by clinician; not primarily comparing clinician types; large difference in numbers between groups;, also included non-RSI cardiac arrest patients |
| First attempt | A = 87.5% |
| EP = 93.1% |
| MO = 85.2% |
| Final success rate | A = 100% |
| EP = 97.3% |
| MO = 90.5% |
| Levitan RMet al, 2004,USA | 658 trauma patients | Prospective observational study | Number of laryngoscopy attempts: | | Observational study; no power study; only major complications; self reported; More numbers in EM groups |
| 1 | EM = 394/456 (86.4%) |
| A = 174/194 (89.7%) |
| 2 | EM = 50 (11%) |
| A = 13 (6.7%) |
| 3 | EM = 12 (2.6%) |
| A = 7 (3.6%) |
| Success | EM = 454/456 (99.6%) |
| A = 194/194 (100%) |
| Cricothyrotomy | EM = 2/456 (0.4%) |
| A = 0 |
| NA 34.2% |
| (No failed intubations in any groups) | M 49.3% |
| (p = 0.23) |
| Bushra JSet al, 2004,USA | 673 trauma patients emergency department, 467 anaesthesia supervised intubations (A), 206 emergency medicine supervised (EM) | Prospective observational study | Successful intubations within 2 attempts | A = 442/467 (94.6%) | Observational study; no power study; no mention of complications; different numbers between groups (EM performed most of the intubations and reported EM intubated in 81% of anaesthesia supervised groups and in 98% of EM supervised groups) |
| EM = 196 (95.1%), odds ratio 1.109 |
| Intubation failure | A = 16/467 (3.4%) |
| EM = 4 (1.9%), odds ratio 0.558 |
| Graham CAet al, 2004,UK | 396 trauma patients in emergency department | Prospective observational study | Complications (oesophageal intubation, endobronchial intubation, aspiration, vomit, critical desaturation, cardiac arrest, hypotensive episode) | EP 11/110 (10.0%) | Observational study; no power study |
| A = 13/123 (10.6%) |
| p = 1.0 |
| Reid Cet al, 2004,UK | 208 RSIs outside theatre, 51 by anaesthetists (A), 82 by non-anaesthetists (NA), 75 by non-anaesthetists supervised by anaesthetists (M) | Prospective observational study | Complications (hypotension, arrhythmias, and hypoxia) | A 33.3% | Observational study; no power study; no record of duration of hypoxia/hypotension; no comparison of seniority of operator; other complications not included. (When compared with conditions and expected complication rates, no statistical differences between groups) |
| NA 34.2% |
| (No failed intubations in any groups) | M 49.3% |
| (p = 0.23) |