Abstract
Choking remains a leading cause of accidental death and morbidity worldwide. Currently, there is no device to assist in the resuscitation of a choking victim when standard maneuvers fail. A novel portable non-powered suction device (LifeVac; LifeVac LLC, Nesconset, NY) has been developed and may have potential use in patients with oropharyngeal dysphagia who are at increased risk of choking. The device is FDA registered and distributed worldwide. This case series provides a summary of self-reported data regarding the use of the suction device in adult patients with oropharyngeal dysphagia during real-world choking emergencies recorded between January 2014 and July 2020. Over a 6-year monitoring period the device has been reported to be successful in the resuscitation of 38 out of 39 patients with oropharyngeal dysphagia during choking emergencies. Although the obstruction was removed with the device from the 39th patient, resuscitation was not successful and he succumbed to his injuries. This portable, non-powered suction device may be useful in resuscitating patients with oropharyngeal dysphagia who are choking. The reported cases describe successful use of the device in real-world settings with minimal risk. Resuscitating patients with oropharyngeal dysphagia using this device may be a viable option when abdominal thrusts or back blows fail to resolve a choking emergency.
Highlights
The swallowing process is a complicated orchestration of skeletal muscles, requiring rapid coordination [1]
In the case of a choking emergency, defined as complete airway obstruction, time is of the essence, as brain damage will occur in 5 min and death will occur in several more minutes without oxygen [4]
Current protocols suggest cardiopulmonary resuscitation (CPR) if abdominal thrusts do not provide a resolution to the choking incident which, without a patent airway, is likely to be futile as well as hazardous in that the object may be forced further into the airway by rescue breaths
Summary
The swallowing process is a complicated orchestration of skeletal muscles, requiring rapid coordination [1]. Current protocols suggest cardiopulmonary resuscitation (CPR) if abdominal thrusts do not provide a resolution to the choking incident which, without a patent airway, is likely to be futile as well as hazardous in that the object may be forced further into the airway by rescue breaths. Over 80,000 units have been distributed worldwide, including to the United Kingdom, Greece, United States, Australia, Israel, and Spain (LifeVac LLC data) This simple-to-use, lightweight, portable, non-powered suction device includes a plunger with a patented one-way valve such that when the plunger is depressed, air is forced out the sides and not into the victim, and when the plunger is pulled back, suction is applied. Upon pulling up on the plunger, the object is removed from the airway (Figure 1) This case series summarizes user-reported implementations of the device in patients with oropharyngeal dysphagia during choking emergencies
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