The Pediatric Bougie for the First Tracheal Intubation Attempt in Critically Ill Children

Laryngoscopy trials: who is putting the tube in the oesophagus?

“…Commentary is perhaps focusing too much on the devices used and too little on the skill levels of those holding them. The greatest differences in outcomes between direct laryngoscopy and videolaryngoscopy exist for those who are the least experienced and who appear to move up the videolaryngoscopy learning curve more quickly [7]. Anaesthetists can appreciate the value of both direct laryngoscopy and videolaryngoscopy in their everyday practice without subscribing to a false narrative that it must be the latter on all occasions.…”

“…In Commentary is perhaps focusing too much on the devices used and too little on the skill levels of those holding them. The greatest differences in outcomes between direct laryngoscopy and videolaryngoscopy exist for those who are the least experienced and who appear to move up the videolaryngoscopy learning curve more quickly [7].…”

More on deaths from unrecognised oesophageal intubation

“…In the light of the DEVICE trial [10], social media have been awash with interpretation and opinion. A promoted view is that we should focus on "the wizard not the wand" and that "the device does not matter provided the operator is skilled with it" and there is a sense of this in Lyons' final paragraph.…”

Paediatric non‐theatre emergency airway management

“…However, use remains relatively low, despite evidence indicating advantages over direct laryngoscopy in achieving first-pass tracheal intubation success in children [2] and fewer adverse events in adults [3,4]. It is notable that the use of videolaryngoscopy was significantly lower in this paediatric population when compared with contemporaneous adult practice in the same hospitals [1].…”