The question “how many angels can dance on the head of a pin?” is sometimes used as a rhetorical illustration of the futility of meaningless or esoteric debate, and in the paper by Clements et al,¹ which discusses whether children in the prehospital environment should be treated with a cuffed or uncuffed tracheal tube, the authors come quite close to trying to count those angels.

Contrary to the image conjured up of teams of paediatric airway specialists poised to descend on sick children in the community, the reality is somewhat different. The vast majority of children will be treated …