- 27 de junio de 2024
Article of interest - Knowledge and skills of pediatric residents in managing pediatric foreign body airway obstruction using novel airway clearance devices in Spain: A randomized simulation trial
Aida Carballo-Fazanes, Verónica Izquierdo, Juan Mayordomo-Colunga, José Luis Unzueta-Roch, Antonio Rodríguez-Núñez
Resuscitation Plus. Volume 19, September 2024, 100695
New collaborative article of interest of the RICORS-SAMID network
This article presents the results obtained from a multicenter study that evaluated if Pediatric residents at CHUS (Santiago), at HUCA (Oviedo) and at Niño Jesús Hospital would be able to resolve a situation of choking due to a foreign body with the anti-choking devices that are available in many places (shopping centers, airports, restaurants...) and also if they would know how to apply the recommended protocol of the European Resuscitation Council (ERC).
Abstract
Aim: Recent emergence of airway clearance devices (ACDs) as a treatment alternative for foreign body airway obstructions (FBAO) lacks substantial evidence on efficacy and safety. This study aimed to assess pediatric residents’ knowledge and skills in managing a simulated pediatric choking scenario, adhering to recommended protocols, and using LifeVac© and DeCHOKER© ACDs.
Methods: Randomized controlled simulation trial, in which 60 pediatric residents from 3 different hospitals (median age 27 [25.0–29.9]; 76.7% female) were asked to solve an unannounced pediatric simulated choking scenario using three interventions to manage (randomized order): 1) following the recommended protocol of the European Resuscitation Council (encouraging to cough or combination of back blows and abdominal thrusts); 2) using LifeVac©; and 3) using DeCHOKER©. A Little Anne QCPR™ manikin (Laerdal Medical) was used. The variable compliance rate (%) was calculated according to the correct/incorrect execution of the steps constituting the proper actions for each test.
Results: Participants demonstrated a correct compliance rate only ranging between 50–75% in following the recommended protocol for managing partial FBAO progressing to severe. Despite unfamiliarity with the ACDs, pediatric residents achieved rates between 75% and 100%, with no significant difference noted between the two devices (p = 0.173). Both scenarios were successfully resolved in under a minute, with LifeVac© demonstrating a significantly shorter response time compared to DeCHOKER© (39.2 [30.4–49.1] vs. 45.1s [33.7–59.2], p = 0.010).
Conclusions: Only a minority of pediatric residents were able to adhere to the recommended FBAO protocol, whereas 70% of them were able to adequately use the ACDs. However, since a significant proportion could not, it seems that ACDs themselves do not address all issues.