- 27 de junio de 2024
Artículo de interés - 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
Nuevo artículo colaborativo de interés para la RICORS-SAMID
Este artículo presenta los resultados obtenidos de un estudio multicéntrico que evaluó si los residentes de Pediatría del CHUS (Santiago), del HUCA (Oviedo) y del H. Niño Jesús serían capaces de resolver una situación de atragantamiento por cuerpo extraño con los dispositivos antiatragantamiento que están disponibles en muchos lugares (centros comerciales, aeropuertos, restaurantes...) y también si sabrían aplicar el protocolo recomendado por el European Resuscitation Council (ERC)
Resumen
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.