Home › Airway & ventilation › Miller vs Macintosh blade in paediatric intubation

Airway & ventilation

Miller vs Macintosh blade in paediatric intubation

Initial Laryngoscope Blade Selection and Outcomes in Paediatric Emergency Department Intubations: Miller vs. Macintosh
Emergency Medicine Australasia · Added 27 July 2026

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

Study type

Registry

Design

Prospectively collected registry cohort (ANZEDAR)

Participants

201 children under 5 intubated in ED

Main finding

Macintosh blades had higher FPS (80.5% vs 63.6%; OR 0.42, 95% CI 0.22–0.80) and lower hypoxia (17.7% vs 33.0%; OR 2.28, 95% CI 1.19–4.46) than Miller; hypotension rates did not differ

Caveat

Miller-blade children were substantially younger, making age a significant confounder; in-hospital ED setting

Bottom line

Hypothesis-generating

Learning goal

Weigh the choice of curved versus straight laryngoscope blades when intubating young children, considering age-related factors.

More

• Topic: Airway & ventilation
• Daily scan: 27 July 2026

Related papers on Airway & ventilation

• High adverse event rate after prehospital RSI

  Prehospital Emergency Care · 4 Aug 2026 · Cross-sectional · Supports current practice

  Investigates the prevalence of adverse events following prehospital airway management using neuromuscular blockade

• Mechanical vs manual ventilation in CPR equal

  Resuscitation · 3 Aug 2026 · Systematic review · Context only

  This systematic review of 13 articles (six RCTs, seven non-randomised studies) found very low to low certainty evidence showing no significant difference in ROSC between volume-controlled mechanical ventilation and manual ventilation during CPR.

• Awake intubation by emergency physicians feasible

  Annals of Emergency Medicine · 27 Jul 2026 · Other · Context only

  In this preliminary single-center study, emergency physicians performed awake intubation with relatively high incidence, high overall success, and low rates of major adverse events.

• Hypopharyngeal perforation after King laryngeal tube

  Prehospital Emergency Care · 27 Jul 2026 · Case series · Context only

  Hypopharyngeal perforation is a rare but serious complication of prehospital King laryngeal tube placement.