Mary Lyn Stein

BACKGROUND: The Paediatric Difficult Intubation Collaborative identified multiple attempts and persistence with direct laryngoscopy as risk factors for complications in children with difficult tracheal intubations and subsequently engaged in initiatives to reduce repeated attempts and persistence with direct laryngoscopy in children. We hypothesised these efforts would lead to fewer attempts, fewer direct laryngoscopy attempts and decrease complications.

We read the Correspondence by Senthil and colleagues 1 Senthil K Daly Guris RJ Vutskits L Lockman JL The law of unintended consequences: the crutch of video laryngoscopy. Lancet Respir Med. 11: e75-76 with interest. We agree that direct laryngoscopy can be a challenging skill to learn and teach, but disagree with several of their statements. Without any evidence, the authors postulate that the advantages that video laryngoscopes have in training will result in poor direct-laryngoscopy skills.