• Ruth Shaylor, Carolyn F Weiniger, Evgeny Rachman, Yarden Sela, Aryeh Kohn, Sharon Lahat, Ayelet Rimon, and Tali Capua.
• From the Department of Anesthesia, Tel Aviv Sourasky Medical Center.
• Pediatr Emerg Care. 2023 Mar 1; 39 (3): 159161159-161.

IntroductionVideo laryngoscopy (VL) has been proposed to increase the likelihood of successful intubation in patients with predicted difficult airways such as those with Pierre Robin sequence (PRS). Prior studies have focused on the performance of anesthesiologists, who are generally considered airway experts. Our primary aim was to investigate the success rate of intubation using VL compared with direct laryngoscopy (DL) when attempted by pediatric residents on a PRS model.MethodsParticipants were administered a 5-minute refresher video on 2 VL techniques (CMAC, conventional geometry VL, and McGrath, unconventional geometry VL) and DL. The participants were asked to intubate the AirSim PRS infant manikin. The order of VL and DL use was randomly selected. All intubations were video recorded, and the recordings were analyzed by 3 anesthesiologists blinded to the participant's identity and previous experience.ResultsSeventeen of 23 residents succeeded in intubating the PRS model using DL. Only 9 residents succeeded in intubating the PRS model using VL (conventional or unconventional geometry). Intubation success rate was higher when comparing DL with VL ( P = 0.04) and similar when comparing VL devices ( P = 0.69).DiscussionContrary to expectation, the intubation success rate was lower using VL than with DL among pediatric residents. This should be considered when designing residency training and in real-life resuscitation.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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