Prehospital removal improves neurological outcomes in elderly patient with foreign body airway obstruction

Igarashi, Yutaka; Yokobori, Shoji; Yoshino, Yudai; Masuno, Tomohiko; Miyauchi, Mutsumi

doi:10.1016/j.ajem.2017.04.016

Cited by 33 publications

(35 citation statements)

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“…This study showed a significant relationship between FB removal by a bystander and favourable neurological outcome. 27 Our more recent study included 386 patients in eight EDs showed that almost half of the patients had favourable neurological outcome (CPC 1 or 2) if FBAO was resolved less than 5 min, but the rate dropped to 28% if FBAO was not successfully treated until 6–10 min. However, the studies included a relatively small number of patients, and there was also a large number of patients with missing time data due to the retrospective design.…”

Section: Discussionmentioning

confidence: 93%

Protocol for a nationwide prospective, observational cohort study of foreign-body airway obstruction in Japan: the MOCHI registry

et al. 2020

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IntroductionForeign body airway obstruction (FBAO) is a major public health issue worldwide. In 2017, there were more than 5000 fatal choking cases in the USA alone, and it was the fourth leading cause of preventable injury-related death in the home and community. In Japan, FBAO is the leading cause of accidental death and with almost 9000 fatalities annually. However, research on FBAO is limited, particularly on the impact of a foreign body (FB) removal manoeuvres by bystanders. The primary objective of this study is to determine the impact of bystander FB removal manoeuvres on 1 month neurological outcome. Our secondary objectives include (1) evaluating the efficacy of a variety of FB removal manoeuvres; (2) identifying risk factors for unsuccessful removal and (3) evaluating the impact of time intervals from incidents of FBAO to FB removal on neurological outcome.Methods and analysisWe will conduct a nationwide multi-centre prospective cohort study of patients with FBAO who present to approximately 100 emergency departments in both urban and rural areas in Japan. Research personnel at each participating site will collect variables including patient demographics, type of FB and prehospital variables, such as bystander FB removal manoeuvres, medical interventions by prehospital personnel, advanced airway management and diagnostic findings. Our primary outcome is 1 month favourable neurological outcome defined as cerebral performance category 1 or 2. Our secondary outcomes include success of FB removal manoeuvres and complications from the manoeuvres. We hypothesise that bystander FB removal manoeuvres improve patient survival with a favourable neurological outcome.Ethics and disseminationThis study received research ethics approval from Nippon Medical School Hospital (B-2019-019). Research ethics approval will be obtained from all participating sites before entering patients into the registry. The study was registered at the University Hospital Medical Information Network (UMIN) Clinical Trials Registry.Trial registration numberUMIN 000039907.

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Section: Discussionmentioning

confidence: 93%

Protocol for a nationwide prospective, observational cohort study of foreign-body airway obstruction in Japan: the MOCHI registry

et al. 2020

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“…Die Leitlinien für die Behandlung von FBAO, die nach der systematische Überprüfung durch ILCOR und CoSTR [ 115 , 146 ] erstellt wurden, unterstreichen die Bedeutung einer frühzeitigen Intervention durch einen Ersthelfer [ 147 , 148 ].…”

Section: Evidenz Die Den Leitlinien Zugrunde Liegtunclassified

“…Eine Person, die bei Bewusstsein und in der Lage ist, zu husten, soll dazu ermutigt werden, da Husten einen hohen und anhaltenden Druck in den Atemwegen erzeugt und den Fremdkörper ausstoßen kann [ 147 , 149 , 150 ]. Eine aggressive Behandlung mit Rückenschlägen, Oberbauchstößen und Brustkompressionen birgt ein gewisses Verletzungsrisiko und kann die Blockierung ggf.…”

Section: Evidenz Die Den Leitlinien Zugrunde Liegtunclassified

Basic life support

Olasveengen

Semeraro²,

Ristagno

et al. 2021

Notfall Rettungsmed

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Der Europäische Rat für Wiederbelebung hat diese Leitlinie – Basismaßnahmen zur Wiederbelebung – auf Grundlage des International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations 2020 erstellt. Die behandelten Themen umfassen: Erkennen eines Herz-Kreislauf-Stillstands, Alarmierung des Rettungsdiensts, Herzdruckmassage (Thoraxkompressionen), Beatmung/Atemspende, automatisierte externe Defibrillation (AED), Qualitätsmessung der Wiederbelebung, neue Technologien, Sicherheit und Verlegung der Atemwege durch Fremdkörper.

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“… Intervention Outcome Studies No. of Patients Results Back blows Survival 1 observational 277 13 All 13 patients survived Relief of obstruction 3 observational 277 , 278 , 279 75 All 75 patients had relief of obstruction Injury/harm 5 observational 280 , 281 , 282 4 3 vascular injuries, 1 thoracic injury Abdominal thrusts Survival 2 observational 283 , 284 189 All 189 patients survived Relief of obstruction 6 observational 277 , 278 , 279 , 283 , 284 , 285 417 All 417 patients had relief of obstruction Injury/harm 49 observational 281 , 282b , 286 , 287 , 288 , 289 , 290 , 291 , 292 , 293 , …”

Section: Special Circumstancesmentioning

confidence: 99%

“…For the important outcome of relief of FBAO, we identified very-low-certainty evidence from 4 case series studies 278 , 285 , 343 , 344 reporting successful relief of FBAO in 417 patients treated with Magill forceps.…”

Section: Special Circumstancesmentioning

confidence: 99%

Adult Basic Life Support

Berg¹,

Soar²,

Andersen³

et al. 2020

Resuscitation

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This 2020 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care Science With Treatment Recommendations on basic life support summarizes evidence evaluations performed for 20 topics that were prioritized by the Basic Life Support Task Force of the International Liaison Committee on Resuscitation. The evidence reviews include 16 systematic reviews, 3 scoping reviews, and 1 evidence update. Per agreement within the International Liaison Committee on Resuscitation, new or revised treatment recommendations were only made after a systematic review. Systematic reviews were performed for the following topics: dispatch diagnosis of cardiac arrest, use of a firm surface for CPR, sequence for starting CPR (compressions-airway-breaths versus airway-breaths-compressions), CPR before calling for help, duration of CPR cycles, hand position during compressions, rhythm check timing, feedback for CPR quality, alternative techniques, public access automated external defibrillator programs, analysis of rhythm during chest compressions, CPR before defibrillation, removal of foreign-body airway obstruction, resuscitation care for suspected opioid-associated emergencies, drowning, and harm from CPR to victims not in cardiac arrest. The topics that resulted in the most extensive task force discussions included CPR during transport, CPR before calling for help, resuscitation care for suspected opioid-associated emergencies, feedback for CPR quality, and analysis of rhythm during chest compressions. After discussion of the scoping reviews and the evidence update, the task force prioritized several topics for new systematic reviews.

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Prehospital removal improves neurological outcomes in elderly patient with foreign body airway obstruction

Cited by 33 publications

References 12 publications

Protocol for a nationwide prospective, observational cohort study of foreign-body airway obstruction in Japan: the MOCHI registry

Protocol for a nationwide prospective, observational cohort study of foreign-body airway obstruction in Japan: the MOCHI registry

Basic life support

Adult Basic Life Support

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