Pre-hospital rapid sequence induction: Factual inaccuracies?

Abstract

This distinction is of some importance when considering the educational background of those practicing RSI, as ECPs hold a four-year degree in emergency medical care (EMC). On page 633, and again on page 636, the authors describe RSI training as being a ‘two day university course’ and that they consider this to be insufficient. [1] I agree that two days of training on RSI is insufficient. However, this is not an accurate description of current RSI education at all institutions offering the EMC degree programme. The ‘two day university course’ was offered once in 2009 by one institution for those who already held an EMC degree, as a way of incorporating RSI (which was newly-approved at the time) into their clinical practice. The important point is that it was a ‘once-off ’ arrangement intended to update those who qualified with an EMC degree before RSI was approved for ECP scope of practice; it has not been the approach followed for undergraduate students since 2010. At the University of Johannesburg (UJ), RSI has been incorporated into an educational strategy on airway management which spans four years. Our approach in designing and implementing RSI education since 2010 has involved advice, input and involvement from specialists in both anaesthesiology and emergency medicine. Assessments include a mix of theory, objective structured clinical evaluations, simulations and assessments carried out in the emergency centre and pre-hospital environments. While we would like all of our students to have clinical experience in RSI before qualifying as independent practitioners, there is a very real problem of access to critical procedures. The healthcare system caters for a large number of students from a variety of fields and institutions. All compete for clinical experience in a small number of facilities that have suitable levels of clinical supervision. Given these constraints, we are currently implementing the approach outlined in the position statement referred to by the authors in their