Guidelines 2024: Emergency intubation of an adult outside the operating room and intensive care unit
Abstract
Objective: To provide guidelines for guidelines on adult patient intubation in emergency settings outside the operating room and intensive care unit. Design: A consensus committee of 24 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société Française d'Anesthésie et de Réanimation, SFAR) and the French Society of Emergency Medicine (Société Française de Médecine d'Urgence, SFMU) was convened. A formal conflict-of-interest (COI) policy was developed at the beginning of the process and enforced throughout. The entire guideline developpement process was conducted independently of any industrial funding (e.g., pharmaceutical or medical device companies). The authors were required to follow the rules of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide the assessment of the quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. Methods: The aim of these expert panel guidelines is to evaluate adult patient intubation in emergency settings outside the operating room and intensive care unit. The experts studied questions within 5 domains. Each question was formulated according to the PICO (Population, Intervention, Comparison, Outcome) model, and the evidence profiles were produced. An extensive literature review and recommendations were carried out and analysed according to the GRADE® methodology. Results: The experts' synthesis and the application of the GRADE® method yielded 32 recommendations for adult patient intubation in emergency settings outside the operating room and intensive care unit. Among the formalised recommendations, 5 have high levels of evidence (GRADE 1), and 12 have low levels of evidence (GRADE 2). For 15 recommendations, the GRADE method could not be applied, resulting in expert opinions. 4 questions did not find any response in the literature. After 4 rounds of scoring and amendment, strong agreement was reached for all the recommendations. Conclusions: There was strong agreement among experts for 36 recommendations to improve practices for adult patient intubation in emergency settings outside the operating room and intensive care unit.
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BibTeX
@article{clavier2026guidelines,
title = {{Guidelines 2024: Emergency intubation of an adult outside the operating room and intensive care unit}},
author = {Thomas Clavier and Eric Cesareo and Denis Frasca and Frédéric Adnet and Marie-Pierre Bonnet and Nathalie Bruneau and Xavier Combes and Julie Contenti and Anne-Laure Feral-Pierssens and Michel Galinski and Jérémy Guenezan and Cédric Gil-Jardine and Alice Hutin and Samir Jaber and Déborah Jaeger and François Javaudin and Olivier Langeron and Karine Nouette-Gaulain and Benoit Plaud and Julien Pottecher and Hervé Quintard and Karim Tazarourte and Stéphane Travers and Fanny Vardon and Amélie Vromant and Stéphanie Ruiz and Anthony Chauvin},
journal = {Anaesthesia Critical Care \& Pain Medicine},
year = {2026},
month = oct,
doi = {10.1016/j.accpm.2026.101744},
url = {https://hal.science/hal-05475209v2},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Guidelines 2024: Emergency intubation of an adult outside the operating room and intensive care unit
AU - Thomas Clavier
AU - Eric Cesareo
AU - Denis Frasca
AU - Frédéric Adnet
AU - Marie-Pierre Bonnet
AU - Nathalie Bruneau
AU - Xavier Combes
AU - Julie Contenti
AU - Anne-Laure Feral-Pierssens
AU - Michel Galinski
AU - Jérémy Guenezan
AU - Cédric Gil-Jardine
AU - Alice Hutin
AU - Samir Jaber
AU - Déborah Jaeger
AU - François Javaudin
AU - Olivier Langeron
AU - Karine Nouette-Gaulain
AU - Benoit Plaud
AU - Julien Pottecher
AU - Hervé Quintard
AU - Karim Tazarourte
AU - Stéphane Travers
AU - Fanny Vardon
AU - Amélie Vromant
AU - Stéphanie Ruiz
AU - Anthony Chauvin
PY - 2026
DA - 2026/10/28
JO - Anaesthesia Critical Care & Pain Medicine
DO - 10.1016/j.accpm.2026.101744
UR - https://hal.science/hal-05475209v2
AB - Objective: To provide guidelines for guidelines on adult patient intubation in emergency settings outside the operating room and intensive care unit. Design: A consensus committee of 24 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société Française d'Anesthésie et de Réanimation, SFAR) and the French Society of Emergency Medicine (Société Française de Médecine d'Urgence, SFMU) was convened. A formal conflict-of-interest (COI) policy was developed at the beginning of the process and enforced throughout. The entire guideline developpement process was conducted independently of any industrial funding (e.g., pharmaceutical or medical device companies). The authors were required to follow the rules of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide the assessment of the quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. Methods: The aim of these expert panel guidelines is to evaluate adult patient intubation in emergency settings outside the operating room and intensive care unit. The experts studied questions within 5 domains. Each question was formulated according to the PICO (Population, Intervention, Comparison, Outcome) model, and the evidence profiles were produced. An extensive literature review and recommendations were carried out and analysed according to the GRADE® methodology. Results: The experts' synthesis and the application of the GRADE® method yielded 32 recommendations for adult patient intubation in emergency settings outside the operating room and intensive care unit. Among the formalised recommendations, 5 have high levels of evidence (GRADE 1), and 12 have low levels of evidence (GRADE 2). For 15 recommendations, the GRADE method could not be applied, resulting in expert opinions. 4 questions did not find any response in the literature. After 4 rounds of scoring and amendment, strong agreement was reached for all the recommendations. Conclusions: There was strong agreement among experts for 36 recommendations to improve practices for adult patient intubation in emergency settings outside the operating room and intensive care unit.
SN - 2352-5568
ER -