When are randomised trials unnecessary? Picking signal from noise

Although efficacy of the "Mother's Kiss" technique for removal of a
foreign body lodged in a nostril may be demonstrated sufficiently by a
report of a case series in which it was successful in 15 out of 19
cases,and thereby, precludes futher randomized trials for demonstration of
treatment effect, no mention of safety is made.

The authors in fact go so far as to recommend the technique:

A search yields only one report of a case series, in which the
mother's kiss was successful in 15 out of 19 children. We think this is
sufficient evidence to recommend use in practice without randomised
trials.

On first blush, the technique does not seem obviously safe, as
compared to visualizing the object and removing it with forceps. It sounds
like performing the pulmonary portion of CPR on a living, breathing
person. Is it not possible that the increased airway pressure may not be
such a good idea?

Competing interests:
None declared