PedsCrit Controversies in Pediatric Critical Care Airway Management with Alex Bragg, Chichi Egbuta & Sapna Kudchadkar (2/2)
Jan 12, 2026
Dr. Chinyere Egbuta, a pediatric anesthesiologist at Boston Children's Hospital, joins Dr. Alex Bragg and Dr. Sapna Kudchadkar to discuss vital airway management strategies in critically-ill children. They debate the effectiveness of video laryngoscopy versus direct laryngoscopy and the importance of maintaining traditional skills. The panel shares practical tips like using patient photos for training and emphasizes humility in seeking help. They highlight how LMAs can be crucial rescue devices and the need for ongoing skill refreshers in a fast-paced environment.
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Make Video Laryngoscopy Your Default
- Use video laryngoscopy routinely in the PICU to facilitate faster, safer intubations.
- Teach trainees to start with indirect VL for their first several intubations and then transition to direct technique when appropriate.
Prioritize Direct Technique For Alignment Skills
- Teach direct laryngoscopy first so trainees learn optimal airway alignment and tube-passing skills.
- Emphasize positioning and tube-passing practice because VL view quality doesn't guarantee easy tube placement.
Don't Let The Screen Distract You
- Looking at the screen too early can make trainees forget the patient in their hands and cause trauma.
- Start by looking at the patient and mouth, then allow screen use once basic maneuvers are safe.