Abstract Sun107: Comparison of Foreign Body Airway Obstruction Interventions Among Laypersons: A Simulation-based, Crossover, Randomized Controlled Trial
Bibliographic record
Abstract
Background: Foreign body airway obstruction (FBAO; choking) can quickly lead to respiratory arrest&death. As FBAOs occur in prehospital settings, survival depends heavily on bystander intervention. Suction-based airway clearance devices (ACDs) are marketed as safer alternatives to traditional maneuvers such as abdominal thrusts. While a previous mannequin study found the LifeVac ACD more effective than AT among healthcare professionals, laypersons are the intended users. Research Question: Among laypersons, which FBAO intervention—abdominal thrusts (AT), LifeVac ACD (LV), or Dechoker ACD (DC)—is most efficacious at relieving an FBAO within one minute? Methods: We conducted a simulation-based, open-label, randomized crossover trial in Alberta, Canada. Adult laypersons received standardized in-person instruction on AT, LV, and DC. Each participant responded to three separate simulated FBAO events (one per intervention), with random assignment to one of six intervention order groups. The outcomes were FBAO relief at one minute (primary) and at four minutes (secondary). Attempts were videotaped and outcomes were assessed by two independent hypothesis-blinded adjudicators. A mixed-effects logistic regression model estimated odds ratios (OR) for FBAO relief, adjusted for sequence, carryover, and period effects. Skill retention was evaluated 90–120 days later without retraining, using the same simulation protocol. Target sample size was 132. Results: Over 7 months, 136 participants were enrolled; 132 were eligible and randomized. Most were female (66%), with a median age of 39 (IQR:26-56). Sixty-eight participants (52%) had current first aid certification, while 40 (30%) had never received first aid training. Adjudicators had perfect outcome agreement (Cohen’s k=1.0). FBAO relief at one minute occurred in 86% (LV), 62% (DC), and 49% (AT) of cases; at four minutes: 97% (LV), 81% (DC), 52% (AT). Compared to AT, LV (OR=12.4; 95%CI: 5.6–27.2) and DC (OR=2.1; 95%CI: 1.2–3.8) had higher odds of one-minute relief. Results were similar at four minutes. In the retention phase, 39 participants returned. At one minute, LV remained superior (OR=97.7; 95%CI: 6.3–1549), while DC did not (OR=1.4; 95%CI: 0.5–4.0); similar findings were observed at four minutes. Conclusion: After brief training, both ACDs were more efficacious than abdominal thrusts in relieving a simulated FBAO among laypersons. However, at 3–4 months post-training, only LifeVac ACD retained superior efficacy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".