Table 2 Grouped and condensed items for Foreign Body Airway Obstruction Management
Foreign Body Airway Obstruction Management | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
Item number | Item | Description | Delphi round | Responses (n) | Distribution of likert ratings (%) | Wilcoxon signed-rank test (p-value) | ||||
1 | 2 | 3 | 4 | 5 | ||||||
1 | Identify different stages of foreign body airway obstruction | Ability to distinguish effective and ineffective cough | Second | 26 | 0 | 0 | 12 | 46 | 42 | 0.58 |
Third | 23 | 0 | 0 | 4 | 65 | 30 | ||||
2 | Identify consciousness | Recognition of unresponsiveness | Second | 26 | 4 | 0 | 4 | 27 | 65 | 0.12 |
Third | 23 | 0 | 0 | 0 | 13 | 87 | ||||
3 | Call for help | Recognize need for help and alert surroundings | Second | 26 | 0 | 0 | 4 | 27 | 69 | 0.75 |
Third | 23 | 0 | 0 | 9 | 17 | 74 | ||||
4 | Back blows | High quality back blows with adequate force and correct place of impact | Second | 26 | 4 | 0 | 0 | 35 | 62 | 0.49 |
Third | 22 | 0 | 5 | 9 | 18 | 68 | ||||
5 | Chest thrusts/abdominal thrusts according to age | High quality chest thrust or abdominal thrust according to age | Second | 26 | 0 | 0 | 4 | 31 | 65 | 0.16 |
Third | 22 | 0 | 0 | 0 | 27 | 73 | ||||
6 | Identify loss of consciousness and change to CPR | Ability to recognize changes in condition and act appropriately | Second | 26 | 0 | 0 | 4 | 15 | 81 | 0.66 |
Third | 23 | 0 | 0 | 0 | 17 | 83 | ||||
7 | Non technical skills | Diagnose possible foreign body airway obstruction and act on prevention, situational awareness, communication skills, use of available resources | Second | 26 | 4 | 12 | 31 | 35 | 19 | 0.13 |
Third | 23 | 4 | 13 | 52 | 30 | 0 | ||||
8 | Adherence to algorithm / time factor | Ability to follow guidelines and minimise time delay in treatment | Second | 26 | 0 | 4 | 27 | 58 | 12 | 0.3 |
Third | 22 | 0 | 9 | 32 | 59 | 0 | ||||
9 | Assessment of effect and recovery position | Ability to recognise changes in condition (check mouth for foreign object between interventions) and act appropriately | Second | 26 | 0 | 12 | 27 | 46 | 15 | 0.75 |
Third | 23 | 0 | 0 | 48 | 48 | 4 | ||||
10 | Mouth inspection | Inspection and removal of visualized objects if confident item can be removed. This item concerns active actions to remove foreign objects if confident they can be removed | Second | 25 | 0 | 12 | 28 | 32 | 28 | 0.43 |
Third | 23 | 0 | 13 | 35 | 39 | 13 | ||||
11 | Airway | Adequate airway management (Altered in third round to) Ability to position head according to age to open airway | Second | 24 | 8 | 0 | 17 | 29 | 46 | 0.52 |
Third | 22 | 14 | 9 | 14 | 14 | 50 | ||||
12 | Assessment of breathing | Ability to assess breathing and recognition of respiratory arrest or abnormal breathing requiring ventilator support | Second | 26 | 0 | 0 | 8 | 42 | 50 | 0.75 |
Third | 21 | 0 | 0 | 5 | 57 | 38 | ||||
13 | Ventilation | Providing high quality ventilations if patient stops breathing. Ability to provide ventilations with chest rise | Second | 25 | 4 | 4 | 0 | 36 | 56 | 0.26 |
Third | 22 | 0 | 0 | 5 | 32 | 64 | ||||
14 | Modification of algorithm | Appropriate action of continued compressions and call for help when not wanting or able to do ventilations (if CPR is needed) | Second | 26 | 12 | 12 | 27 | 35 | 15 | 0.38 |
Third | 23 | 9 | 9 | 48 | 26 | 9 | ||||
15 | Complete/ incomplete obstruction | Ability to recognize complete or incomplete obstruction | Second | 26 | 0 | 19 | 35 | 27 | 19 | 0.5 |
Third | 22 | 0 | 9 | 64 | 18 | 9 | ||||