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May I thank Sen and Nichani1 for their recent “Best Bet” on prehospital intubation in head injury. It was a pity, however, that they neglected to look deeper into the reasons why their conclusion, at least at this point in time, was that there is insufficient evidence to support its use. The very topic of prehospital rapid sequence induction (RSI) was the subject of a panel discussion and presentation at the National Association of Emergency Medical Service Physicians annual meeting in Arizona in 2004. Fortunately, they delved deeper into the issues surrounding RSI in patients with …