This second edition handbook details new and improved procedures, current drugs and updated algorithms used by the crews of the Great North Air Ambulance who have been providing this life saving intervention since 2004. It will be of interest to pre-hospital care doctors and trainees, especially those studying for the GNAAS course.

Pre-Hospital Anaesthesia is one of the most demanding interventions that can be made in the field. The exact incidence of failed intubation is difficult to quantify, but it is clear that it is higher than in hospital. Equally it is certain that anyone undertaking it should have clear instruction in the technique and a thorough understanding of all it entails.

Jeremy Henning, MB BCH, FRCA, Consultant in Anaesthesia and Critical Care St James Cook University Hospital, Middlesbrough, and British Army and HEMS Consultant at the Great North Air Ambulance. Henning has previous experience in being an SHO In Emergency Medicine at Morrison Hospital, General Duties Medical Officer 1 Armd Fd Amb, SHO in Anaesthesia Wessex , SHO in Medicine Royal Hospital Haslar, SpR in Anaesthesia Tri Service Deanery, Retrieval Fellow and at Royal Adelaide Hospital Airborne Intensive Care Unit.

Andrew Griffiths, B Med Sci (Hons), MB BS, FRCA, Consultant in Anaesthesia and Critical Care and British Army and HEMS Consultant at the Great North Air Ambulance. Griffiths has previous experience as an SHO in Anaesthesia South (West) Thames Deanery, SHO in Medicine Truro, SHO in Emergency Medicine Mansfield, SpR in Anaesthesia Tri Service Deanery.

Tim Lowes, MB BS, FRCA, DiplMC, Consultant in Anaesthesia and Critical Care and British Army and HEMS Consultant at the Great North Air Ambulance. Lowes has previous experience as an SpR in Anaesthesia Tri Service Deanery.

1. Introduction.- 2. Indications and Decision Making.- 3. Pre-Hospital Rapid Sequence Intubation (PRSI).- 4. Crew Resource Management (CRM).- 5. Post-Intubation Management.- 6. Equipment and Minimum Monitoring Standards.- 7. Drugs and Sedation.- 8. Special Circumstances.- 9. Complications, Adverse Events and Clinical Governance.