Hi;
I think I can give you some help. As Medical Director of both Flight for Life (rotorwing) program in Colorado Springs and AMR(ground based ambulance with paramedics) in Colorado Springs - I can gove you numbers form both agencies, since both do RSI.
Over thje past three years Flight for Life (FFL) has a 100% success rate acheiving a tracheal intubation with RSI. This is almost always in the first attempt. I can recall two or three times when intubation has required more than one but less than three attempts. I am not counting the total number of attempts in the 100% figure. To me, if the airway is acheived in three attempts or less, that is a 100% success rate. We fly about 400 patients a year and probably 30 % of these patients are RSi'd.
On our ground based paramedic ambulance, we have utilized RSI of one year. At this point, we have attempted 58 RSIs with a 94% success rate. Again the same definition regarding successful airway placement described above applies here. AMR Colorado Springs transports about 300 critical airway patients per year, out of a total number of 30,000 transports per year.
By the way, cricothyrotomy is not viewed as a bailout airway option in wither agency if RSI fails. We use BVM and/or the Combitube or LMA Fastrach as alternate airways. So far, we have only had to go to a cric once in in the past five years in an RSI patient that could not be intubated at FFL. We have not needed to go to a cric at all at AMR. The key to success for RSI is proper patient selection.
Hope this helps. Let me know if you need more info.
Dave Ross
