Where possible, videolaryngoscopy should be used for tracheal intubation in patients with suspected or confirmed cervical spine injury (Grade A; moderate recommendation). We are unable to recommend a particular type of videolaryngoscope or a specific type of blade.

Clinicians who perform tracheal intubation in patients with suspected or confirmed cervical spine injury should receive regular training in the use of videolaryngoscopy with cervical spine immobilisation (Grade D; weak recommendation).

Clinicians should consider using an adjunct such as a stylet or bougie when performing tracheal intubation in a patient whose cervical spine is immobilised (Grade D; weak recommendation).

If cricoid force is used, it should be carried out by individuals who have received appropriate training (Grade D; weak recommendation).

If difficulty in tracheal intubation is encountered when cricoid force is used, it should be removed (Grade D; weak recommendation).

If laryngeal injury is suspected, cricoid force should be avoided (Grade D; weak recommendation).

Cautious external laryngeal manipulation may be used to improve glottic view during tracheal intubation (Grade D; weak recommendation).

Emergency front-of-neck airway access should be obtained in line with the Difficult Airway Society guidelines (Grade D; weak recommendation).

If a patient is considered to be at risk of failed tracheal intubation, ultrasound guidance may be used to identify and mark the cricothyroid membrane before induction of anaesthesia, if resources and skill mix are appropriate. This may be done with a cervical collar in situ (Grade C; weak recommendation).

The decision to choose awake vs. a anaesthetised tracheal intubation and/or to use a flexible bronchoscope should be made on a case-by-case basis, considering patient factors, equipment availability and the proficiency of the clinician with the technique (Grade D; weak recommendation).