Effectiveness of the Abdominal Thrust Maneuver for Airway Obstruction Removal: Analysis of Data from the National Emergency Medical Services Information System.

ABSTRACT

BACKGROUND: Foreign body airway obstruction (FBAO) is a life-threatening emergency. Abdominal thrusts are recommended as first aid, but the success rate for this technique is unclear. Using information from a large database of emergency medical services (EMS) data in the United States, we evaluated the success rate of abdominal thrusts and identified patient characteristics that were associated with the success of the technique. METHODS: A retrospective observational study was conducted using data from the National Emergency Medical Services Information System (NEMSIS) to ascertain the success of abdominal thrusts in patients with FBAO from nearly 14,000 EMS agencies. Success was defined by positive evaluations on subjective and objective EMS criteria. RESULTS: Analysis of 1,947 cases yielded a 46.6% success rate for abdominal thrusts in removing obstructions. The age distribution was bimodal, with peaks during infancy and old age. June had the highest incidence of FBAO. Incidents were most frequent during lunch and dinner times, and most cases occurred in private residences. The first-time success rate was 41.5%, and a lower level of impaired consciousness was associated with lower success rates. A lower incidence of cardiac arrest was noted in successful cases. The success rate was high (60.2%) for children (age ≤15 years), with differences in demographic characteristics and a lower rate of impaired consciousness and cardiac arrests, as compared with unsuccessful interventions in the same age group. CONCLUSIONS: Our study showed a 46.6% success rate for abdominal thrusts in patients with FBAO. The success group had a lower proportion of impaired consciousness and cardiopulmonary arrest than the failure group. Future studies should attempt to identify the most effective maneuvers for clearing airway obstruction.