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Do Video Calls Improve Dispatcher-Assisted First Aid for Infants with Foreign Body Airway Obstruction? A Randomized Controlled Trial/Simulation Study

Yutaka Igarashi¹, Kensuke Suzuki², Tatsuya Norii³, Tomokazu Motomura^1,4, Yudai Yoshino^1,5, Yutaka Kitagoya⁶, Satoo Ogawa², Shoji Yokobori¹ and Hiroyuki Yokota²

¹Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
²Department of Emergency Medical Science, Nippon Sport Science University, Kanagawa, Japan
³Department of Emergency Medicine, University of New Mexico, Albuquerque, United States
⁴Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
⁵Department of Emergency and Critical Care Medicine, Aidu Chuo Hospital, Fukushima, Japan
⁶Department of Paramedic Science, Kyoto Tachibana University, Kyoto, Japan

Background: Because choking quickly leads to cardiopulmonary arrest, it is crucial that bystanders remove foreign bodies effectively. Although oral instructions in video calls by dispatchers have improved the quality of cardiopulmonary resuscitation, it is unclear whether video calls improve the quality of first aid for choking infants. Therefore, this simulation study aimed to determine whether video calls with dispatchers improve the quality of first aid for infants with foreign body airway obstruction (FBAO).
Methods: Seventy first-year college students randomly assigned in pairs to communicate by video or audio calls participated in simulated emergency calls for infants with FBAO. Both groups began with oral instruction in voice calls until the transition was made to video calls in the video group. The primary outcome was quality of first aid performance, which was categorized as excellent, acceptable, or poor on the basis of existing guidelines.
Results: There were 17 simulations in the video-call groups and 16 in the voice-call groups. After initial oral instruction, the proportion of rescuers that received an evaluation of excellent or acceptable did not differ significantly between the groups (video, 41% vs. voice, 50%; P=0.61); however, evaluations for seven rescuers improved after transitioning to video calls. Ultimately, the proportion receiving a poor evaluation was significantly lower in the video-call group than in the voice-call group (50% vs. 82%, P=0.049).
Conclusion: Oral instruction communicated by video calls improved the quality of first aid for infants with FBAO.

J Nippon Med Sch 2022; 89: 526-532

Keywords
airway obstruction, first aid, pediatric emergency medicine, emergency ambulance system, prehospital care

Correspondence to
Yutaka Igarashi, MD, PhD, Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
igarashiy@nms.ac.jp

Received, March 17, 2022
Accepted, May 13, 2022