title: Effectiveness of prehospital Magill forceps use for out-of-hospital cardiac arrest due to foreign body airway obstruction in Osaka City.
abstract: BACKGROUND
  Although foreign body airway obstruction (FBAO) accounts for many preventable unintentional accidents, little is known about the epidemiology of FBAO patients and the effect of forceps use on those patients. This study aimed to assess characteristics of FBAO patients transported to hospitals by emergency medical service (EMS) personnel, and to verify the relationship between prehospital Magill forceps use and outcomes among out-of-hospital cardiac arrests (OHCA) patients with FBAO.
  
  
  METHODS
  We retrospectively reviewed ambulance records of all patients who suffered FBAO, and were treated by EMS in Osaka City from 2000 through 2007, and assessed the characteristics of those patients. We also performed a multivariate logistic-regression analysis to assess factors associated with neurologically favorable survival among bystander-witnessed OHCA patients with FBAO in larynx or pharynx.
  
  
  RESULTS
  A total of 2,354 patients suffered from FBAO during the study period. There was a bimodal distribution by age among infants and old adults. Among them, 466 (19.8%) had an OHCA when EMS arrived at the scene, and 344 were witnessed by bystanders. In the multivariate analysis, Magill forceps use for OHCA with FBAO in larynx or pharynx was an independent predictor of neurologically favorable survival (16.4% [24/146] in the Magill forceps use group versus 4.3% [4/94] in the non-use group; adjusted odds ratio, 3.96 [95% confidence interval, 1.21-13.00], p = 0.023).
  
  
  CONCLUSIONS
  From this large registry in Osaka, we revealed that prehospital Magill forceps use was associated with the improved outcome of bystander-witnessed OHCA patients with FBAO.
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka Suita, Osaka 565-0871, Japan. t-sakai@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Sakai
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
authors.forename: Taku
authors.initials: T
authors.lastname: Iwami
authors.forename: Chika
authors.initials: C
authors.lastname: Nishiyama
authors.forename: Kayo
authors.initials: K
authors.lastname: Tanigawa-Sugihara
authors.forename: Sumito
authors.initials: S
authors.lastname: Hayashida
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nishiuchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kajino
authors.forename: Taro
authors.initials: T
authors.lastname: Irisawa
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Shiozaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogura
authors.forename: Osamu
authors.initials: O
authors.lastname: Tasaki
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kuwagata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hiraide
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimazu
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000150:complications / Q000628:therapy*; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000628:therapy*; D006801:Humans; D007830:Larynx; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology / Q000628:therapy*; D010614:Pharynx; D012042:Registries; D012189:Retrospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome