LifeVac and Dechoker pose alternative to abdominal thrusts
The Ache: Nearly 5,000 people a year die from choking in the U.S., according to the nonprofit National Safety Council.
The Claim:
Two new easy-to-use devices work like plungers to suck out obstructions
in the airway, providing another option if standard treatment—such as
abdominal thrusts developed in 1974 by Henry Heimlich—fail to clear the airway, say the companies who sell them.
The Verdict: A recently published laboratory study showed the LifeVac, from
LifeVac LLC
of Springfield Gardens, N.Y., dislodged simulated obstructions. So far
there haven’t been any scientific publications detailing lives saved
with the LifeVac or another device, from
Dechoker LLC, of Salisbury, N.C.
Both the Dechoker, $89.95, and the LifeVac, $69.95, have a plastic
mask that provides a seal over the mouth and nose while suction is
provided. The Dechoker looks like a large syringe, while the LifeVac’s
plunger is shaped like a small accordion. In both devices, one-way
valves allow air to only travel out of the mask and not into it, which
avoids pushing the object deeper in, says LifeVac Chief Executive
Arthur Lih.
While the devices “theoretically” could work, there isn’t enough evidence for them, says New Orleans physician Jay Kaplan,
president of the American College of Emergency Physicians. There are a
number of potential pitfalls, including whether a panicking choking
victim would let a rescuer put a mask on the mouth, he adds.
Early adopters of the devices include people with chronic diseases at
high risk for choking. “This is a very simple device which people can
have on hand,” says Port Charlotte, Fla., neurologist William Holt. He
says he recommends the LifeVac to his multiple-sclerosis patients, as
the disease interferes with the muscular coordination involved in
swallowing. Dr. Holt says he works as a volunteer adviser to LifeVac but
has no financial link to the company.
Skeptics include Dr.
Heimlich, now 96. Such a device may not be handy in the “unexpected
instance that a person chokes,” Dr. Heimlich, a retired thoracic surgeon
from Cincinnati, says in a statement released by his son, Phil
Heimlich. “Any action that delays use of the Heimlich maneuver or
complicates the rescue can be deadly.”
If
a person is choking and isn’t able to cough out the obstruction, the
American Heart Association recommends a rapid sequence of abdominal
thrusts. If that doesn’t work, or if you can’t get your arms around the
victim, due to obesity or pregnancy, another option is thrusting around
the chest area, adds Clifton Callaway, chairman of the AHA’s Emergency
Cardiovascular Care committee. The American Red Cross recommends using
five back blows, followed by five abdominal thrusts, repeating as
needed.
The LifeVac and the Dechoker are both intended to be used
if standard rescue treatments fail, the companies say. One person can
get the device while another person starts the Heimlich maneuver,
suggests Sean Pittman, Dechoker’s director of strategic development.
The
American Heart Association, which last updated its guidelines on
choking rescue in 2010, looks for published reports in scientific
journals that a technique has a record of successful uses before
recommending it, the group says.
On the market less than two years, neither LifeVac nor Dechoker has
published evidence of successful uses in humans. Two users have told
Dechoker that the device successfully dislodged an obstruction, says Mr.
Pittman. In a recent case of an elderly woman in Wales, the LifeVac
removed an obstruction after standard treatments failed, says Mr. Lih.
The company doesn’t yet have full details on the case, he adds.
In a
study published online in March in the American Journal of Emergency Medicine,
the LifeVac successfully removed test obstructions made of clay from
the upper airway of a cadaver. “It worked 49 out of 50 times on the
first try,” says study co-author Mimi Juliano, a Farmingdale, N.Y.,
speech pathologist who specializes in swallowing disorders. The one time
the device failed on the first try, researchers didn’t have a good seal
around the mouth, she says; it worked the second time.
Source By:
http://www.wsj.com/articles/can-new-devices-match-heimlich-to-stop-choking-1468242002