Knowledge and skills of pediatric residents in managing pediatric foreign body airway obstruction using novel airway clearance devices in Spain: A randomized simulation trial

Carballo Fazanes, AidaIzquierdo Vázquez, VerónicaMayordomo Colunga, JuanUnzueta Roch, José LuisRodríguez Núñez, Antonio2025-10-242025-10-242024-09Carballo-Fazanes, A., Izquierdo, V., Mayordomo-Colunga, J., Unzueta-Roch, J. L., & Rodríguez-Núñez, A. (2024). Knowledge and skills of pediatric residents in managing pediatric foreign body airway obstruction using novel airway clearance devices in Spain: A randomized simulation trial. Resuscitation Plus, 19, Article 100695. https://doi.org/10.1016/j.resplu.2024.1006952666-5204https://hdl.handle.net/10347/43389Aim: Recent emergence of airway clearance devices (ACDs) as a treatment alternative for foreign body airway obstructions (FBAO) lacks substantial evidence on efficacy and safety. This study aimed to assess pediatric residents' knowledge and skills in managing a simulated pediatric choking scenario, adhering to recommended protocols, and using LifeVac© and DeCHOKER© ACDs. Methods: Randomized controlled simulation trial, in which 60 pediatric residents from 3 different hospitals (median age 27 [25.0-29.9]; 76.7% female) were asked to solve an unannounced pediatric simulated choking scenario using three interventions to manage (randomized order): 1) following the recommended protocol of the European Resuscitation Council (encouraging to cough or combination of back blows and abdominal thrusts); 2) using LifeVac©; and 3) using DeCHOKER©. A Little Anne QCPR™ manikin (Laerdal Medical) was used. The variable compliance rate (%) was calculated according to the correct/incorrect execution of the steps constituting the proper actions for each test. Results: Participants demonstrated a correct compliance rate only ranging between 50-75% in following the recommended protocol for managing partial FBAO progressing to severe. Despite unfamiliarity with the ACDs, pediatric residents achieved rates between 75% and 100%, with no significant difference noted between the two devices (p = 0.173). Both scenarios were successfully resolved in under a minute, with LifeVac© demonstrating a significantly shorter response time compared to DeCHOKER© (39.2 [30.4-49.1] vs. 45.1s [33.7-59.2], p = 0.010). Conclusions: Only a minority of pediatric residents were able to adhere to the recommended FBAO protocol, whereas 70% of them were able to adequately use the ACDs. However, since a significant proportion could not, it seems that ACDs themselves do not address all issues.eng© 2024 The Authors. Creative Commons CC-BY-NCAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/Basic Life SupportChoking emergencyDeCHOKERFBAOLifeVacTraining320110 Pediatría321305 Cirugía de garganta, nariz y oídosKnowledge and skills of pediatric residents in managing pediatric foreign body airway obstruction using novel airway clearance devices in Spain: A randomized simulation trialjournal article10.1016/j.resplu.2024.100695open access