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jueves, 14 de julio de 2016

HEIMLICH MANEUVER vs LifeVac (DeschO2ker) for Airway Obstructions

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.
HEIMLICH MANEUVER vs LifeVac (DeschO2ker) for Airway Obstructions 

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.

Taken from http://www.wsj.com/articles/can-new-devices-match-heimlich-to-stop-choking-1468242002

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