Mind the gap: can videolaryngoscopy bridge the competency gap in neonatal endotracheal intubation among pediatric trainees? a randomized controlled study

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BACKGROUND:To study the impact of videolaryngoscopy (VL) on intubation success among pediatric trainees compared with direct laryngoscopy (DL).METHODS:One hundred pediatric residents were enrolled in a randomized, crossover, simulation study comparing VL to DL. Following a didactic session on neonatal intubation, residents intubated a standard neonatal mannequin. Three Neonatal Resuscitation Program (NRP) scenarios were then conducted, followed by a mannequin intubation with the alternate device. Number of attempts and time to intubation were recorded for all intubations.RESULTS:Proportion of successful intubations on first attempt was greater with VL compared with DL (88% versus 63%; P = 0.008). The DL group increased success after crossover with VL (63% versus 89%; P = 0.008). Exposure to VL also reduced intubation time after device crossover (median intubation time: 31 versus 17 s; P = 0.048).CONCLUSIONS:VL increased the success of endotracheal intubation by pediatric residents in simulation, with skills transferrable to DL.

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