{
  "abstract": "Paediatricians routinely balance individual patient care needs with training the next generation of clinicians. An important example is tracheal intubation. Should inexperienced trainees perform tracheal intubation, or is this critical intervention best left to more experienced clinicians? If the answer is more experienced clinicians, how do junior trainees become experienced? The tension between patient care and training has always existed, but it has become especially prominent in discussions of airway management due to clear evidence linking severe complications with the number of tracheal intubation attempts.1 A second question in airway management further complicates this debate: Is direct laryngoscopy or video laryngoscopy the best option, particularly when working with trainees? Robust evidence shows that video laryngoscopy has higher success rates, lower complication rates and fewer failed tracheal intubation attempts across various patient care settings, including operating rooms, intensive care units, delivery rooms and emergency departments.2–4 Given the strength of the high-quality evidence, some have asked if there is a place for traditional direct laryngoscopy in the care of paediatric patients in 2026 and onwards? While these questions are important, they highlight a blind spot in discussions of video and direct laryngoscopy—great for arguments and editorials, but less helpful for patient care and medical education. Both issues can be addressed with a simple approach: video-assisted direct laryngoscopy (VADL).",
  "authors": [
    {
      "affiliations": [
        "Department of Anesthesiology Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA",
        "Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Stephen Gerard Flynn"
    },
    {
      "affiliations": [
        "Department of Anesthesiology Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA",
        "Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Mary Lyn Stein"
    },
    {
      "affiliations": [
        "Department of Anesthesiology Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Samuel Y Kim"
    },
    {
      "affiliations": [
        "Department of Anesthesiology Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA",
        "Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Raymond S Park"
    },
    {
      "affiliations": [
        "Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil",
        "Discipline of Anesthesiology, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil"
      ],
      "name": "Gabriel Soares de Sousa"
    },
    {
      "affiliations": [
        "Department of Anesthesiology Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA",
        "Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Pete G Kovatsis"
    },
    {
      "affiliations": [
        "Department of Anesthesiology Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA",
        "Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "James M Peyton"
    }
  ],
  "title": "Complementary views: addressing blind spots in the direct versus video laryngoscopy debate",
  "uid": "2e82bb6a-df42-546e-a73d-ca49f094dd58"
}