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Back blows outperformed abdominal thrusts and chest compressions in successful clearance of out-of-hospital foreign body airway obstructions (FBAO).
Heimlich maneuver chokes in primetime
This observational cohort study compared the efficacy of basic life support (BLS) methods for FBAO – abdominal thrusts, back blows, and chest compressions. 709 all-ages cases of FBAO requiring intervention were included, with the primary outcome of FBAO relief and secondary outcomes of survival to discharge and intervention-associated injuries. The plurality of patients were over 65 years old (n=260), and the next largest age group was 1 year or less (n=191). Performed in Canada, researchers utilized patients’ healthcare identification number to link prehospital, emergency department, and hospital data. In all-comers, odds of FBAO relief were better for back blows when compared with abdominal thrusts (aOR 0.55, 95%CI 0.38-0.80) and chest compressions (aOR 0.11, 95%CI 0.11-0.38). There was no difference in odds of survival to discharge between back blows and abdominal thrusts, though chest compressions underperformed (aOR 0.16, 95%CI 0.05-0.55). 10 intervention-associated injuries were identified, most of which were associated with chest compressions, and none attributed to back blows. Notably, patients who received their first intervention from a paramedic as opposed to a bystander accounted for a significantly greater proportion of deaths (23% vs 13%, p<0.001)…meaning, bystander intervention saves lives!
Source
Evaluation of basic life support interventions for foreign body airway obstructions: A population-based cohort study. Resuscitation. 2024 Aug;201:110258. doi: 10.1016/j.resuscitation.2024.110258. Epub 2024 May 31. PMID: 38825222
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