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. 2023 Nov 8:16:100496.
doi: 10.1016/j.resplu.2023.100496. eCollection 2023 Dec.

A 2-year prospective evaluation of airway clearance devices in foreign body airway obstructions

Cody L Dunne  1   2 , Kayla Viguers  3 , Selena Osman  4 , Ana Catarina Queiroga  2   5   6 , David Szpilman  2   7 , Amy E Peden  2   8   9
Affiliations

A 2-year prospective evaluation of airway clearance devices in foreign body airway obstructions

Cody L Dunne et al. Resusc Plus. .

Abstract

Aim: To collect, analyze and report the first prospective, industry-independent, data on airway clearance devices as novel foreign body airway obstruction interventions.

Methods: We recruited adult airway clearance device users between July 1, 2021 and June 30, 2023 using a centralized website and email follow-up. The data collection tool captured patient, responder, situation, and outcome variables. Multi-step respondent validation occurred using electronic and geolocation verification, a random selection follow-up process, and physician review of all submitted cases.

Results: We recruited 186 airway clearance device users (LifeVac©:157 [84.4%]; Dechoker©:29 [15.6%]). LifeVac© was the last intervention before foreign body airway obstruction relief in 151 of 157 cases. Of these, 150 survived to discharge. A basic life support intervention was used before LifeVac© in 119 cases, including the 6 cases where LifeVac© also failed. We identified two adverse events using LifeVac© (perioral bruising), while we could not ascertain whether another 7 were due to the foreign body or LifeVac© (3 = airway edema; 3 = oropharyngeal abrasions; 1 = esophageal perforation). Dechoker© was the last intervention before obstruction relief in 27 of 29 cases and all cases survived. A basic life support intervention was used before Dechoker© in 21 cases, including both where Dechoker© also failed. We identified one adverse event using Dechoker© (oropharyngeal abrasions).

Conclusion: Within these cases, airway clearance devices appear to be effective at relieving foreign body airway obstructions. However, this data should be considered preliminary and hypothesis generating due to several limitations. We urge the resuscitation community to proactively evaluate airway clearance devices to ensure the public remains updated with best practices.

Keywords: ACD; Anti-choking; Basic life support; FBAO; Prehospital; Resuscitation.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors have no competing interests, financial or otherwise, to declare. The research team approached the manufacturers to seek their participation in this study. Manufacturers of airway clearance devices agreed to participate in the study in two areas: identification and recruitment of participants and distributing the research data collection tool as needed. Manufacturers were not involved in study design, nor do they have any financial involvement. Manufacturers do not have access to the collected data, nor have they been permitted to view the results or manuscripts prior to publication. Dr. Amy Peden is funded by a National Health and Medical Research Council (NHMRC) Emerging Leadership Fellowship (Grant ID: APP2009306) which supported open access publication. No funding was obtained for the conduct of the study.

Figures

Fig. 1
Fig. 1
Flow of data collection tool responses.
Fig. 2
Fig. 2
Comparison of Likert responses between LifeVac© (top) and Dechoker© (bottom) users describing their experience.
See this image and copyright information in PMC

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