{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T15:13:19Z","timestamp":1762528399715,"version":"build-2065373602"},"reference-count":56,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>(1) Background: Ground Emergency Medical Services in Hungary are provided by the National Ambulance Service. Paramedics, physicians, and specialists in this service are competent in performing endotracheal intubation (ETI) on patients. The aim of this study is to evaluate the impact of the standardized Rapid Sequence Intubation (RSI) procedure on safety and effectiveness. (2) Methods: A retrospective observational study was conducted concerning the RSI procedure. Patient documentation from a 2-year implementation period was analyzed using a dedicated Case Report Form (CRF), where both RSI and non-RSI methods were used. Our primary endpoint was Definitive Airway Sans Hypoxia and Hypotension on First Attempt (DASH-1A). Our secondary endpoints included success on the first attempt; overall success; and hypoxia, hypotension, and cardiac arrest complications. (3) Results: In total, 6399 intubation cases were studied; non-RSI was used in 3236, and RSI was applied in 3163 cases. DASH-1A was attained in a significantly higher number of cases with RSI than non-RSI (55.0 vs. 68.5%, p &lt; 0.0001). The DASH-1A results of the RSI group were significantly better in the paramedic (54.0 vs. 68.5%, p &lt; 0.0001) and the physician (55.0 vs. 66.7%, p = 0.0017) subgroups. In the specialist subgroup, the difference was not statistically significant (64.5 vs. 69.7%, p = 0.1514). (4) Conclusions: Standardized RSI significantly increased effectiveness and safety in the paramedic and physician subgroups.<\/jats:p>","DOI":"10.3390\/life15111725","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T14:55:15Z","timestamp":1762527315000},"page":"1725","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Standardized Rapid Sequence Intubation (RSI) Improves Effectiveness and Safety in Mixed Physician and Paramedic Hungarian EMS"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1997-5356","authenticated-orcid":false,"given":"B\u00e9la","family":"Bur\u00e1ny","sequence":"first","affiliation":[{"name":"School of PhD Studies, Semmelweis University, 1094 Budapest, Hungary"},{"name":"Emergency Medical Centre, North-Pest Central Hospital\u2014Military Hospital, 1097 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3479-7161","authenticated-orcid":false,"given":"P\u00e9ter","family":"Temesv\u00e1ri","sequence":"additional","affiliation":[{"name":"Emergency Medical Centre, North-Pest Central Hospital\u2014Military Hospital, 1097 Budapest, Hungary"},{"name":"Hungarian Air Ambulance Nonprofit Ltd., 2040 Buda\u00f6rs, Hungary"},{"name":"National Ambulance Service, 1087 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e1rton","family":"Radnai","sequence":"additional","affiliation":[{"name":"Hungarian Air Ambulance Nonprofit Ltd., 2040 Buda\u00f6rs, Hungary"},{"name":"National Ambulance Service, 1087 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2310-8642","authenticated-orcid":false,"given":"\u00c1kos","family":"S\u00f3ti","sequence":"additional","affiliation":[{"name":"Hungarian Air Ambulance Nonprofit Ltd., 2040 Buda\u00f6rs, Hungary"},{"name":"Department of Emergency Medicine, Semmelweis University, 1094 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"Csukly","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, Semmelweis University, 1094 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6425-7620","authenticated-orcid":false,"given":"G\u00e1bor","family":"\u00c9l\u0151","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Semmelweis University, 1094 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/s13054-015-0808-x","article-title":"Prehospital endotracheal intubation: Elemental or detrimental?","volume":"19","author":"Pepe","year":"2015","journal-title":"Crit. 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