May 26, 1993

Cardiopulmonary Resuscitation-Reply

Author Affiliations

Vanderbilt University School of Medicine Nashville, Tenn American Heart Association
University of Connecticut Health Center Farmington American Heart Association

JAMA. 1993;269(20):2625-2626. doi:10.1001/jama.1993.03500200039019

In Reply.  —We appreciate the opportunity to clarify the scientific data available regarding relief of airway obstruction in infants. Scientific literature must meet rigorous criteria to justify recommendations for new treatment options. Unique aspects of pediatric cardiorespiratory anatomy and physiology prevent the application of most data derived from adult human or animal models to pediatric resuscitation. After elimination of reports of adult choking victims, anesthetized victims, victims with partial airway obstruction, and isolated case reports, the Pediatric Resuscitation Subcommittee could find few scientific data regarding relief of complete airway obstruction in infants or children. The points raised by Dr Gibbons are not supported by scientific data.The Pediatric Resuscitation Subcommittee found no scientific data that back blows and chest thrusts fail to relieve complete foreign-body airway obstruction in infants. In fact, deaths due to foreign-body airway obstruction in children up to 4 years of age decreased 60% from more than