Prospective evaluation of basic life support interventions for foreign body airway obstructions: A pilot population-based cohort study

Background: Foreign body airway obstruction (FBAO) is a life-threatening emergency; however, bystander treatment recommendations rely on retrospective data. We evaluated the feasibility of a population-based prospective cohort study of FBAO interventions. Methods: We conducted a prospective observational pilot study in Alberta, Canada, between November 2025 and April 2026. We identified individuals with out-of-hospital FBAO who called emergency medical services or attended an emergency department using a validated health-record case definition. Participants were stratified into adults and children (aged>2 years) and younger children (aged< 2 years) cohorts. The primary outcome was included cases per month, with several secondary feasibility (proportion of eligible cases included, data completeness) and clinical outcomes (FBAO relief, survival to acute care discharge, favourable neurological outcome, intervention-associated injuries). Results: Among 5,208 screened encounters, 147 FBAO cases were identified. Of these, 91 adults and children (89.2%) and 39 young children (86.7%) were enrolled. Mean recruitment was 15.2 participants/month (SD=1.1) in the adult and child cohort, exceeding the predefined feasibility threshold ([&ge;]13/month), and 6.5 participants/month (SD=1.3) in the young child cohort, meeting the amber-zone criterion (6-8/month). Data completeness exceeded 90% across all participants. In adults and children, bystander intervention relieved the obstruction in 59 cases (66.3%), and 80(87.9%) survived to acute care discharge. In young children, bystander intervention relieved the obstruction in 33 cases (84.6%); all survived with favourable neurological outcomes. Conclusions: Prospectively identifying and recruiting individuals with FBAO is feasible using population-based prehospital and emergency department records. These findings support a larger adequately powered prospective cohort study comparing the effectiveness and safety of FBAO interventions.