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) is a life-threatening emergency where rapid bystander intervention is essential. Suction-based airway clearance devices like Dechoker (DC) and LifeVac (LV) are marketed alternatives to abdominal thrusts (AT), but their efficacy among laypersons is unclear. We aimed to determine which intervention (AT, DC or LV) has the greatest efficacy for FBAO relief by laypersons. Methods: We conducted a simulation-based, crossover, randomized controlled trial. Adult laypersons received standardized in-person instruction on AT, DC, and LV, then responded to three simulated FBAO events on an adult mannequin. A mixed-effects logistic regression model estimated the odds ratios (OR) of FBAO relief at one minute (primary outcome) and four minutes (secondary), adjusted for carryover effects. Skill retention was evaluated 90-120 days later without retraining. Results: Of 139 participants, 132 were eligible and randomized. Median age was 39 years (IQR: 26-56), and 66 % were female. At one minute, FBAO relief occurred in 86 % (LV), 62 % (DC), and 49 % (AT) of cases. LV had greater odds of relief than AT (OR = 12.4 [95 %CI 5.6-27.2]) and DC (OR = 5.8 [95 % CI 2.8-12.1]). Compared with AT, DC also had greater odds of relief (OR = 2.1 [95 %CI 1.2-3.8]). At four minutes, results were similar. During follow-up testing, LV remained superior to AT (OR = 97.7 [95 %CI 6.3-1549]), while DC did not. Conclusion: After brief training, LifeVac was superior to abdominal thrusts and Dechoker for simulated FBAO relief among laypersons. Research evaluating LifeVac's safety and effectiveness in a controlled clinical setting is now needed. Trial registration: ClinicalTrials.gov Identifier: NCT06227234.
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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 | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 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".