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Two papers and an accompanying editorial discuss videolaryngoscopy. Changes in staffing and in clinical practice mean that trainees get precious few opportunities to intubate and are frequently unsuccessful. In a randomised controlled trial videolaryngoscopy improved trainee success rate. Now Joyce O’Shea and colleagues have analysed the videos from the unsuccessful intubation attempts in the trial to see what the problem was. Some trainees simply didn’t know what they were looking at. Failure to recognise the anatomy could be overcome in advance with good teaching tools and this paper includes useful videos as on-line files that could be used to support training. Sometimes the trainees knew what they were looking at but couldn’t get the tube to go where they wanted. This may partly be due to device design. In a separate study reported by Marie-Eve Robinson where videolaryngoscopy was used in infants getting attempted airway suction for meconium, the videos showed that the trainees were not successful at entering the trachea nearly as frequently as they thought. There are a couple of nice videos with this paper too. With less invasive surfactant administration becoming increasingly popular and trainee intubation success rates so low it …
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