Emergency department airway management-2026: EMAT clinical policy guideline

Şeref Kerem Çorbacıoğlu; Gökhan Aksel; Başak Bayram; Ersin Aksay; Faruk Danış5; 6; Fatma Sarı Doğan; Emir Ünal8; 9; Mehmet Muzaffer İslam; Emre Kudu8; 9; Alp Şener10; 11; Murtaza Kaya; Göksu Bozdereli Berikol; Fatma Nur Karaarslan; Merve Osoydan Satıcı; Volkan Arslan; Haldun Akoğlu8; 16; Buğra İlhan; Mustafa Emin Çanakçı; Demet Devrimsel; Resul Çinpolat; İbrahim Sarbay; Enis Ademoğlu; Ali Cankut Tatlıparmak; Yaylanur Hande Temizer

doi:10.4103/tjem.tjem_12_26

Şeref Kerem Çorbacıoğlu¹, Gökhan Aksel², Başak Bayram³, Ersin Aksay⁴, Faruk Danış^5,6, Fatma Sarı Doğan⁷, Emir Ünal^8,9, Mehmet Muzaffer İslam², Emre Kudu^8,9, Alp Şener^10,11, Murtaza Kaya¹², Göksu Bozdereli Berikol¹³, Fatma Nur Karaarslan¹⁴, Merve Osoydan Satıcı², Volkan Arslan¹⁵, Haldun Akoğlu^8,16, Buğra İlhan¹⁷, Mustafa Emin Çanakçı¹⁸, Demet Devrimsel¹⁹, Resul Çinpolat¹, İbrahim Sarbay²⁰, Enis Ademoğlu², Ali Cankut Tatlıparmak²¹, Yaylanur Hande Temizer¹⁵

¹Department of Emergency Medicine, Atatürk Sanatoryum Training and Research Hospital, Ankara, Türkiye
²Department of Emergency Medicine, University of Health Sciences, Ümraniye Training and Research Hospital, İstanbul, Türkiye
³Department of Emergency Medicine, İzmir Metropolitan Municipality Eşrefpaşa Hospital, İzmir, Türkiye
⁴Department of Emergency Medicine, School of Medicine, İzmir University of Economics, İzmir, Türkiye
⁵Department of Emergency Medicine, School of Medicine, Bolu Abant İzzet Baysal University, Bolu, Türkiye
⁶Department of Emergency Medicine, Bolu İzzet Baysal Training and Research Hospital, Bolu, Türkiye
⁷Department of Emergency Medicine, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, İstanbul, Türkiye
⁸Department of Emergency Medicine, School of Medicine, Marmara University, İstanbul, Türkiye
⁹Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
¹⁰Department of Emergency Medicine, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Türkiye
¹¹Department of Emergency Medicine, Ministry of Health Ankara Bilkent City Hospital, Ankara, Türkiye
¹²Department of Emergency Medicine, Kütahya Health Sciences University, Kütahya City Hospital, Kütahya, Türkiye
¹³Department of Emergency Medicine, School of Medicine, Atılım University, Ankara, Türkiye
¹⁴Department of Emergency Medicine, Manisa Soma State Hospital, Manisa, Türkiye
¹⁵Department of Emergency Medicine, School of Medicine, Hacettepe University, Ankara, Türkiye
¹⁶Department of Medical Education, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Türkiye
¹⁷Department of Emergency Medicine, Kırıkkale University Faculty of Medicine, Kırıkkale, Türkiye
¹⁸Department of Emergency Medicine, Eskişehir Osmangazi University, Eskişehir, Türkiye
¹⁹Department of Emergency Medicine, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Türkiye
²⁰Department of Emergency Medicine, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, İstanbul, Türkiye
²¹Department of Emergency Medicine, Faculty of Medicine, Üsküdar University, İstanbul, Türkiye

Keywords: Airway management, emergency medicine, intracranial pressure, intratracheal, intubation, ketamine, noninvasive ventilation, oxygen inhalation therapy, patient safety, preoxygenation, vasoconstrictor agents

Abstract

This clinical policy was developed by Emergency Medicine Association of Türkiye (EMAT) to evaluate current evidence on airway management in the emergency department (ED) and to provide clinicians with practical, evidence based recommendations. Although rapid sequence intubation in the ED is a life saving intervention in critically ill patients, the choice of techniques and medications during its implementation has a decisive impact on patient safety and clinical outcomes. This policy was developed by the research committee (RC) using the “Grading of Recommendations, Assessment, Development, and Evaluations (GRADE)” methodology, based on systematic literature reviews and expert opinion. Within the framework of five key clinical questions, the following topics were examined: preoxygenation strategies (noninvasive mechanical ventilation, high flow nasal oxygen, face mask, and conventional techniques); the effectiveness and safety of apneic oxygenation; the use of a gum elastic bougie during intubation; the role of push dose vasopressors in patients at high risk of hypotension; and the safety of ketamine use in patients at risk of increased intracranial pressure. This policy aims to reduce complications related to airway management and improve patient outcomes by providing emergency physicians with an evidence based framework for preintubation preparation, medication selection, and equipment use.

How to cite this article: Çorbacıoğlu SK, Aksel G, Bayram B,Aksay E, Danış F, Doğan FS, et al. Emergency department airway management-2026: EMAT clinical policy guideline. Turk J Emerg Med 2026;26:159-82.