Technical Assessment of Simulated Neonatal Intubation Using Multi-Angle Video

Background: Neonatal intubation is a critical skill, yet trainees may not achieve procedural competency before program completion. This study quantified technical differences between novice and expert intubators using multi-angle and intraoral video during simulated neonatal intubation. Methods: Participants from a level IV NICU—including MDs, NNPs, RNTS’s, and residents—completed three intubations each on preterm and term manikins. Experts were defined as those with >10 successful intubations and >1 year of NICU experience. Outcomes included failure rate, time metrics, glottic view, and laryngoscope hold. Results: Thirty-eight subjects participated (18 novices, 20 experts). Intubation failure did not differ significantly, but experts completed term manikin intubations faster (12.5s vs. 15.8s, p<0.001), visualized cords sooner in preterm trials, and advanced the ETT faster in term trials. Glottic views were similar, though laryngoscope hold technique differed significantly (p=0.006). Conclusion: Objective technique differences may inform targeted training strategies and competency assessment in neonatal airway management.