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After a recent course and chatting to a US paramedic trainer, it became apparent that many US paramedics/ EMT-P are trained to a higher level than UK BASICS docs. RSI is taught to senior paramedics (2 years post qualification experience) in a 2 day course. Drugs of choice - diazepam and sux in Oregon at least Indications - this surprised me, apart from HI they have no problem in zapping severe respiratory distress where patient becoming exhausted, severe pulmonary oedema, and even aggressive psychiatric patients! As a result a paramedic crew would expect about one RSI per month or two. Anecdotal I know, but why the shrowds of mystery in the UK where even RSI in A&E is jealously guarded? No need to repeat v.helpful debate earlier about training, but would be interested if we could use the american experience as a catalyst to further training in UK. Thoughts? Jeremy (GP/ BASICS) %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%