Initial Laryngoscope Blade Selection and Outcomes in Paediatric Emergency Department Intubations: Miller vs…

Cohort studyEmergency medicine Australasia : EMA· Aug 2026

Initial Laryngoscope Blade Selection and Outcomes in Paediatric Emergency Department Intubations: Miller vs. Macintosh.

Andrew Wallace, Hatem Alkhouri, Helen Badge … Elliot Long

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Pediatric Emergency MedicineCohort studyTreatment

Miller blade associated with lower first-pass intubation success than Macintosh in young children

Initial Laryngoscope Blade Selection and Outcomes in Paediatric Emergency Department Intubations: Miller vs. Macintosh.

Andrew Wallace … Elliot Long

Emergency medicine Australasia · Aug 2026

Background

Optimal initial laryngoscope blade selection for paediatric emergency intubation is uncertain.

Methods

Prospectively collected data from the Australia and New Zealand ED Airway Registry (Australia and New Zealand ED Airway Registry) between March 2010 and March 2024 were analysed for children under 5 years of age.

n = 201 children

Results

Miller blade use linked to lower odds of succeeding on the first intubation attempt.

OR by subgroup · 95% CI

More results

Among 201 children, 88 (43.8%) were intubated with a Miller blade and 113 (56.2%) with a Macintosh blade.

Hypotension rates did not differ.

“

Conclusion · 1 of 2

In this cohort of young children intubated in the ED, Macintosh blade use was associated with higher first-pass success and fewer hypoxic events compared with Miller blade.

Conclusion · 2 of 2

Age was a significant confounder and should be considered when choosing which laryngoscope blade to use in young children.

Initial Laryngoscope Blade Selection and Outcomes in Paediatric Emergency Department Intubations: Miller vs. Macintosh.

Initial Laryngoscope Blade Selection and Outcomes in Paediatric Emergency Department Intubations: Miller vs. Macintosh.

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