Lih-Brody, Lisa MD, FACG1; Lih, Arthur2; Brody, Edward Jr. MS3; Singer, Michael4
1. ProHealth Care Associates, Rockville Centre, NY;
2. Lifevac, Massapequa, NY;
3. Lifevac, Rockville Centre, NY;
4. Lifevac, Nesconset, NY.
Introduction: Patients with oropharyngeal dysphagia are at increased risk for choking which can be a leading cause of death in this population. Currently there are no methods to remove an inhaled object if the traditional Heimlich maneuver fails. We have developed an apparatus which is simple to use in order to remove an object lodged in the upper airway if the Heimlich maneuver fails.
Methods: The Laerdaltm Choking Charlie simulator system designed specifically for training for the Heimlich abdominal thrust maneuver was used in order to simulate a choking victim. A Nathans Cocktail Frank cut in half was utilized as this food is responsible for many choking deaths. The item was pushed into the airway 7 cm from the lips in order to create an obstruction in the airway. The Lifevac unit was then utilized per the products instruction manual to attempt to dislodge the object and the frequency of dislodging the object was recorded.
Results: Using Laerdal Choking Charlie with a hot dog piece inserted into the airway the Lifevac successfully removed the object 470 out of 500 attempts in one useage, in 498 out of 500 attempts with two useages, and was successful 500 out of 500 attempts in three useages. The 95% confidence interval for the probability of success (S) of the device (when defining success as removal in one usage) = 91.5% < S < 95.9%. The 95% confidence interval for the probability of success (S) of the device (when defining success as removal in two or fewer usages) = 98.5% < S < 99.9%.
Conclusion: Lifevac is a promising apparatus that is simple to use and appears to be an extremely effective method in successfully dislodging an object lodged in the ariway of a choking victim. Further studies with cadavers and subsequent pilot studies in humans are warranted in the hopes of saving lives when the Heimlich maneuver fails.© The American College of Gastroenterology 2015. All Rights Reserved.