We write describing our experience using the First Access for Shock and Trauma (FAST1) intra-osseous (I/O) cannula to perform a rapid sequence induction (RSI) at the roadside. The casualty was the victim of an RTC with difficult IV access and in urgent need of anaesthesia due to airway compromise and severe head injury. The I/O cannula was sited swiftly and without difficulty despite the patient being in the right decubitus position for postural airway drainage. Onset of anaesthesia/muscle relaxation showed no discernable delay compared with the intravenous route. Fluid flow and cannula security were also adequate.