During the development of our Premature Baby Manikins (first the 28/29 week gestation and then the more recent 22/23 week gestation) we have observed a lack of suitably sized DL & VL equipment designed to deal with these extremely low birth weight babies (i.e. the blade sizes are simply too big!). It would be interesting to share what DL & VL devices you are using as we see a fairly high proportion of failed intubations (or at best too much force being applied to achieve intubation) in the training / simulation setting. While the cause, in part, can be associated with variances in an individuals technique, it is not helped by the seeming lack of suitable equipment. As the 'gestation / viability window' has come down over time, has equipment design kept pace with this and do you use different protocols (including different devices) for different gestations?