NextGen Learning To Elevate Your Airway Practice
Overview
Video laryngoscopy (VL) is increasingly favored due to its advantages in visualization and teaching; DL remains widely used. The choice between VL and DL often depends on equipment availability, clinician experience, and specific patient considerations. As VL technology becomes more accessible and its benefits more recognized, VL is anticipated to play a more prominent role in pediatric airway management.
The Evidence
Recent studies have provided evidence supporting the use of video laryngoscopy (VL) over direct laryngoscopy (DL) in pediatric airway management. A systematic review and meta-analysis concluded that VL reduces the risk of failed first intubation attempts and major complications in children compared to DL. However, the performance of VL devices can vary, and the overall quality of evidence was rated from low to very low. (pubmed.ncbi.nlm.nih.gov)
For Neonates
In neonatal populations, VL has been associated with higher first-attempt intubation success rates and fewer intubation attempts than DL. Additionally, VL likely results in a slight reduction in airway trauma during intubation attempts. However, VL may not significantly reduce the time required for successful intubation. (pubmed.ncbi.nlm.nih.gov)
For Training
For clear reasons, VL is an effective teaching tool. Having a screen makes intubation a team sport. Its use during neonatal intubation and real-time supervisor feedback led to significantly higher intubation success rates than DL. This suggests that VL can enhance intubation skills in medical trainees. (pmc.ncbi.nlm.nih.gov)
Video Laryngoscopes Changing the Game
Size and Shape Matter
This is a quick review of video laryngoscope blades and how they change with the patient’s age, followed by a quick review of the VL technique.
Curated MedEd
Here is a great instructional video by the renowned Cliff Reid, MD, on infant intubation with a video laryngoscope. Please take a moment to watch and learn, and then add him to your learning network.
The Bottom Line
Video laryngoscopy (VL) in pediatric airway management generally improves first-attempt intubation success rates, reduces complications, and is a valuable teaching tool compared to direct laryngoscopy (DL), particularly in neonates. However, the evidence quality varies, and VL does not always significantly reduce intubation time. While VL is gaining preference, DL remains widely used due to factors like availability, clinician experience, and patient-specific considerations. As technology advances, VL is expected to play an increasingly prominent role in pediatric airway management.
Don’t Forget to Practice
Use this content for self-guided practice. When you’re comfortable with your initial progress, visit our expert faculty coaches for customized feedback. You can do this as many times as you like. This iterative practice and feedback process will take your skills to the next level.
What’s Next
Find Or Click Me
Nice work—you’re through this section! To keep going, scan the QR code on the physical poster at the next station in our pop-up training space to access the next set of digital content. Prefer to stay online? Just click the poster image here to continue your journey.
Explore the full pediatric airway management learning space for related lessons on anatomy, equipment and airway preparation.
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