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A short systematic review was undertaken to assess whether the use of non-supine positioning is associated with increased first-pass success in emergency department (ED) intubation. Medline, Embase and Google Scholar databases were searched. Six prospective studies were found, including two randomised trials. A positive association was demonstrated between patient angulation and first-pass success in three studies. These results support the protocolised use of inclined positioning for ED intubation.