The efficacy and usability of suction-based airway clearance devices for foreign body airway obstruction: a manikin randomised crossover trial

Abstract

Background Newly-developed suction-based airway clearance devices potentially provide a novel way to improve outcome in patients with foreign body airway obstruction. We conducted a randomised controlled crossover manikin trial to compare the efficacy and usability of two of these devices with abdominal thrusts. Methods We randomised participants from a UK medical school to one of six groups which determined the order in which participants attempted the three techniques (abdominal thrusts; LifeVac, Nesconset, New York, USA; Dechoker, Concord North Carolina, USA). Randomisation was performed using an online randomisation system. Following brief training, participants sought to remove a foreign body airway obstruction from a manikin using the allocated technique. The primary outcome was successful removal of the foreign body. Usability was assessed in a questionnaire following the three simulations. Results We randomised and analysed data from 90 participants (58% male; 86% aged 18−29 years). Compared with abdominal thrusts, successful foreign body airway obstruction removal was achieved more frequently in manikins in the LifeVac group (odds ratio 47.32, 95% CI 5.75–389.40) but not in the Dechoker group (odds ratio 1.22, 95% CI 0.60–2.47). The usability of LifeVac and abdominal thrusts were generally evaluated more positively than the Dechoker. Conclusion In this manikin study, we found that, compared with abdominal thrusts, the success rate for foreign body airway obstruction removal was higher in the LifeVac group but not in the Dechoker group.