As a stay at home dad, when I'm not a CPR instructor, I get the question from soon to be parents or, parents of young children, I talk to in play dates, "What do you think about those sucking devices when someone is chocking? I've been seeing ads online and I put it on my baby shower wish list." Let me backtrack and describe what these parents are talking about...Negative Pressure Anti-Choking Devices such as the LifeVac.
What is a Negative Pressure Anti-Choking Device?
The LifeVac, a Negative Pressure Anti-Choking Device, describes itself as a device to use when "standard basic life support protocols are not effective when someone is choking".
Lay responders or healthcare professionals attempting to resolve a complete foreign body airway obstruction in a conscious adult or child should first provide up to 5 back blows until the foreign body is relieved or, if not relieved, transition to up to 5 abdominal and/or chest thrusts. If the foreign body is not relieved, they should continue with cycles of 5 back blows followed by 5 abdominal and/or chest thrusts until the obstruction is relieved. - Red Cross 2023 Healthcare Guidelines
In laymen terms it's a plunger attached to a pocket breathing mask designed to simulate a forceful cough on a chocking victim using a non evasive means. According to the training video on lifevac.net, an instructor demonstrates how to use the device on child manikin facing up and claim it can be used on victims who are standing, in a wheel chair, or can be used on yourself.
As of the writing of this blog article, the makers of LifeVac claims 1,701 lives have been saved by their device. LifeVac offers kits for parents, schools, and emergency medical personal.
My initial professional thoughts and concerns about Negative Pressure Anti-Choking Devices
I was hesitant at the thought of this device because I was never trained in it's use and only saw it in a few ads. I tell everyone the best action everyone can do is prevention, especially in children. Prevention is the first chain of the Red Cross Pediatric of Cardiac Chain of Survival. Prevention incudes proper supervision, making sure toys are age appropriate, avoiding foods that can cause choking. Check out my article on foods that can cause choking.
If someone does start to choke, the victims best chances are for a first responder to give a combination of back blows between the victim's scapula using the heel of your hand and abdominal thrusts. I tell people it's easier to use your own hands then scramble to find a device.
I remember sitting down at the dinning room table watching my youngest son in a high chair eat his lunch when all of a sudden, he was not making any noise and couldn't talk, cry or cough. I knew he was choking on his food. On instinct, I went behind my then toddler, released his high chair straps, bent him over and attempted back blows. By the second attempted back blow he spit out the piece of food and was making noise again. My son looked at me smiled and started to eat the food he just spit out. In my head, I can hear him going, "nom, nom, nom" like Cookie Monster from Sesame Street. I share that story because it was my first hand story of quick thinking and action. I think the outcomes would have been different if I tried to do anything else.
What does the American Red Cross say about care for chocking victims and Negative Pressure Anti-Choking Devices?
In the 2023 American Red Cross Healthcare Guidelines state that the best care for someone choking is 5 back blows and 5 abdominal thrusts until the object has been ejected from the victim's airway. If the chocking victim goes unconscious you start CPR and between compressions and breaths you look for an object in airway. You sweep for the object ONLY IF YOU SEE IT using your index finger for adults and older children and your pinky finger for younger children and infants.
When it comes to negative pressure anti-choking devices, like LifeVac, The Red Cross admits that has been some anecdotal evidence of their success but not enough concrete evidence to fully support their use. The Red Cross fears are that lay responders will not have enough training to use the devices correctly and lose valuable time getting the device when back blows and abdominal thrusts will work more effectively when a victim is choking. Manual removal of an object should happen when the victim is unconscious and the object is seen.
If standard first aid for management of choking or foreign body airway obstruction is not effective or not feasible, anti-choking devices may be considered for attempted relief of airway obstruction. - American Red Cross 2023 Healthcare Guidelines
The Red Cross does conclude that anti-choking devices should not be routinely used. "If standard first aid for management of choking or foreign body airway obstruction is not effective or not feasible, anti-choking devices may be considered for attempted relief of airway obstruction." More research and studies are needed for anti-choking devices.
Final Thoughts
These negative pressure anti-choking devices are fairly new and not a lot of people have been trained in it's usage. I don't even own one myself. I agree with the Red Cross, I would be afraid lay responders will try to use the device first rather then standard first aid care. Even the makers of LifeVac agree it's device should only be used after standard protocols have been attempted.
If you are looking for a gift for a soon-to-be-parent or looking for preventive measures for your workplace or school I suggest giving the gift of first aid training. As of this article I provide First Aid training/CPR/AED training to the public two Saturdays a month at the Aurora Regional Fire Museum in Aurora, IL. you can also go to the American Red Cross Training Services Website and look for a provider that fits your schedule.
Citations
Management of Foreign Body Airway Obstruction | Red Cross Guidelines Database. (2023, December). American Red Cross 2023 Healthcare Guidelines. Retrieved January 10, 2024, from https://redcrossdb.wpengine.com/guidelines-database/foreign-body-airway-obstruction/
LifeVac LLC. (2024, January 19). Official Site of LifeVac | Choking Rescue Device that Saves Lives. LifeVac. Retrieved January 24, 2024, from https://lifevac.net/
