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

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.