Emergency department airway management-2026: EMAT clinical policy guideline

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.