Do We Actually Help Choking Children? The Quality of Evidence on the Effectiveness and Safety of First Aid Rescue Manoeuvres: A Narrative Review

Abstract

The management of foreign body airway obstruction has evolved over time from back blows and chest thrusts to abdominal thrusts. However, current guidelines worldwide are based on outdated data, with unclear evidence regarding the effectiveness and safety of these rescue manoeuvres. Concerns persist about the potential of these techniques to cause injury, especially in children; therefore, a critical revision to ensure optimal child safety is necessary. The literature on first aid for paediatric choking was identified through the searching of various databases. Studies were evaluated for their relevance, quality, and currency. The analysis examined guideline consistency with current evidenced-based medicine and identified research gaps. The analysis of the available data was supplemented by adult-based evidence due to the scarcity of paediatric-specific research. First aid guidelines and recommendations for paediatric choking are divergent and generally grounded in low-quality evidence derived primarily from case studies. Studies since 2015 have shown highly diverse methodologies and often lack details on the execution of individual techniques, body positioning or the specific characteristics of study groups, which are crucial when comparing the effectiveness and safety of rescue manoeuvres. Updating evidence-based scientific knowledge for future recommendations is crucial.

Keywords

• first aid
• paediatric
• children
• foreign body airway obstruction
• choking
• airway