Survey of the use of rapid sequence induction in the accident and emergency department

Editor,—The paper by Walker and Brenchley1 highlights a crucial area of emergency medicine practice. The key issues are “How are skills maintained” and “What is an acceptable period of training”. The authors state in their conclusions that the majority of accident and emergency (A&E) consultants thought that rapid sequence induction (RSI) would be undertaken by A&E staff if an anaesthetist were unavailable. If the A&E staff are only performing this procedure rarely then they will become de-skilled and will have a higher complication rate than a colleague performing the procedure on a regular basis. Anaesthesia is defined as an essential secondment for training, why have this secondment if the skills are not going to be actively used. In order to be given the responsibility of “on call” the anaesthesia minimum requirement is three months of supervised training. I feel that it is no coincidence that this also is the length of our secondment. 1. ↵ Survey of the use of rapid sequence induction in the accident and emergency department. Walker A, Brenchley JJ. J Accid Emerg Med 200;17:95–7. # {#article-title-2} Editor,— As a doctor with a background in both anaesthesia and accident and emergency (A&E) medicine, and currently working in an emergency medicine environment, I read the paper by Walker and Brenchley with interest.1 I have been aware for some time now of the debate among emergency physicians, and anaesthetists, over their respective roles in emergency airway management. I suspect …