Direct laryngoscopy versus indirect videolaryngoscopy for intubating newborn manikins: a randomised crossover study

Gaining and maintaining proficiency at endotracheal intubation is challenging. Recent clinical trials suggest videolaryngoscopy is beneficial for teaching inexperienced clinicians to intubate newborn infants, but may take longer compared to standard laryngoscopy. Preferences for devices among clinicians are unclear. Simulation studies using manikins have shown that use of videolaryngoscopes (VLs) likely improves intubation outcomes, at least in the short term. This study is the first to compare different VLs and SL as they are designed in clinicians with varying levels of experience in term and preterm manikins. This setup more closely mimics real-life clinical practice in comparison to trials exclusively of novices or using VL devices to intubate directly. Our study is relevant to members of the perinatal and neonatal clinical care team and related to using technology to improve neonatal outcomes. It is of particular importance in the current environment of reduced opportunities to learn and maintain neonatal intubation skills due to changes in neonatal practice and clinical care.