The International Liaison Committee on Resuscitation (ILCOR) conducted a systematic review on foreign body airway obstruction (Olasveengen et al., 2020). Show
Back blowsOne case series reported the survival of all people treated with back blows. Three case series reported relief of airway obstruction in all people treated with back blows. Four studies reported four cases of injuries or complications in people treated with back blows. Very low-certainty evidence downgraded for very serious risk of bias and/or serious indirectness. Abdominal thrustsSix case series reported survival with the relief of a foreign body airway obstruction in all people treated with abdominal thrusts. However, in 49 studies, cases of injuries or complications were reported in people treated with abdominal thrusts. Very low certainty evidence downgraded for very serious risk of bias. Chest thrusts/ compressionsFor the critical outcome of survival with a favourable neurological outcome, one observational study showed a benefit to using chest compressions. One case series reported relief of a foreign body airway obstruction in people treated with chest thrusts or compressions. Four studies reported five cases with injuries or complications in people treated with chest thrusts or compressions. Very low-certainty evidence downgraded for
very serious risk of bias and/or very serious imprecision. Finger sweepILCOR identified ten observational studies (mainly case series) regarding using a finger sweep. One case series reported survival in all people treated with a finger sweep. Two case series reported relief of foreign body airway obstruction in all people treated with a finger sweep. Very low-certainty evidence downgraded for very serious risk of bias and serious indirectness. Eight studies reported ten cases of injuries or complications in people treated with a blind finger sweep. Very low-certainty evidence downgraded for very serious risk of bias. The studies could therefore not conclude a benefit to using this approach. Foreign body airway obstruction removal by bystanders For the critical outcome of survival with a good neurological outcome, one
observational study showed a benefit to foreign body airway obstruction removal by bystanders, compared with no bystander attempts. Very low-certainty evidence downgraded for very serious risk of bias. OtherThe evidence about the use of Magill forceps or suction-based airway clearance devices is not provided here. Education reviewThe papers we reviewed raised important considerations for learners, particularly concerning a choking baby. Gesicki and Longmore (2019) compared the length of a standard baby manikin with the length of adult forearms. Based on data, they found that the traditional straddle-arm technique was not physically possible for many first aid providers and recommended a more supported version with a seated or kneeling first aid provider. Topic Resources Choking in an infant is usually caused by a small object the baby has placed in its mouth (eg, food, toy, button, coin, or balloon). If the airway obstruction is severe, then back blows followed by chest thrusts are administered to dislodge the object. Severe upper airway obstruction in an infant (under age 1 year), caused by choking on a foreign object. Signs of severe airway obstruction in an infant include
Do not interfere if the infant can cry and make significant sounds, cough effectively, or breathe adequately; such infants do not have severe airway obstruction. Furthermore, strong coughs and cries can help push the object out of the airway. Absolute contraindications
Relative contraindications
Back blows—infantChest thrusts—infantChest thrusts are delivered on the lower half of the sternum, just below the nipple level.
The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource. Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved. Which of the following techniques should you use to dislodge a foreign body airway obstruction in a patient who is?SEVERE OR COMPLETE foreign-body airway obstruction can kill the victim in minutes if he doesn't get appropriate treatment. The primary technique to clear an obstruction in a conscious adult is administration of abdominal thrusts—the Heimlich maneuver.
Which of the following maneuvers should be used to open a patients airway?Airway: The patient's airway is opened by performing a head tilt–chin lift or a jaw thrust. These maneuvers will thereby displace the mandible anteriorly, lifting the tongue and epiglottis away from the glottic opening.
What is the first course of action when a victim with a foreign body airway obstruction becomes unresponsive?When a victim of foreign-body airway obstruction becomes unresponsive (adult, child, or infant) and the rescuer has sent someone to activate emergency response system, immediately start CPR beginning with compressions.
What is the most appropriate treatment for a patient with a mild upper airway obstruction?1. If the patient shows signs of mild airway obstruction, encourage him to continue coughing, but do nothing else. 2. If the patient shows signs of severe airway obstruction and is conscious, give up to five back blows.
|