Foreign body airway obstruction: considerations in 1985.

Management of foreign body airway obstruction continues to be a major controversy in emergency medical care. Much of the disagreement is without doubt based on lack of a uniformly accepted model of acute airway obstruction representative of the clinical event. A variety of models have been used to assess different aspects of airway obstruction by foreign bodies. These models have analyzed, among other variables, kinetic energy and inertial and aerodynamic forces in attempts to focus on specific aspects of this controversy. Human volunteers, anesthetized and paralyzed patients, and cadavers have also been used. In several recent studies it was concluded that subdiaphragmatic pressure is the treatment of choice, while in at least one additional study firm back blows applied with the patient's head hanging downward were recommended as the treatment most likely to relieve airway obstruction. It seems likely that these apparently conflicting views can be reconciled and that a consensus recommendation for treatment of this emergency can be effected.