Non‐operating theatre emergency tracheal intubation: a UK multicentre prospective observational study of rapid sequence induction drugs and adverse events
Authors' conclusion
Patients who required tracheal intubation outside operating theatres experienced high rates of post-induction hypotension. Propofol was the most used induction drug, often at doses typical for elective anaesthesia. Pre-emptive vasopressor use was inconsistent.
Study context
- Population
- Adults requiring emergency tracheal intubation outside the operating theatre, UK NHS hospitals
- Participants
- 250 adults · 23 NHS hospitals
- Outcome
- Selection and dose of induction drugs
Methodological detailsconvenience sample, Data collected as a convenience sample by anaesthetic and critical care teams using an online form
- Convenience sample
- Data collected as a convenience sample by anaesthetic and critical care teams using an online form
Main finding
As reported in the abstract
Induction drugs used in RSI (n=233)
- Propofol used
- 147 (63%)
- Fentanyl used
- 172 (74%)
- Ketamine used
- 53 (23%)
- Midazolam used
- 51 (22%)
- Propofol with fentanyl (most common combination)
- 97/233, 42%
- Propofol dose, median (IQR [range]), mg.kg-1
- 1.4 (0.8-2.0 [0.04-3.3])
- Fentanyl dose, median (IQR [range]), μg.kg-1
- 2.0 (1.3-2.9 [0.5-6.0])
Observational data: associations, not effects.
Secondary outcomes
Subsequent vasopressor administration in patients without pre-emptive vasopressors
- Required vasopressor
- 40/105 (38%)
Safety
Severe hypotension (SBP < 80 mmHg) post-induction
- Patients with recorded post-induction BP
- 24/219 (11%)
Severe hypoxia (SpO2 < 80%) post-induction
- Patients with recorded post-induction SpO2
- 14/221 (6%)
Post-induction cardiac arrest
- Cardiac arrest
- 6/233 (3%)
Original publication
Non‐operating theatre emergency tracheal intubation: a UK multicentre prospective observational study of rapid sequence induction drugs and adverse events. Anaesthesia. Published 29 July 2026. doi:10.
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