P0429 - Resuscitation of pediatric choking victims using the Lifevac, a novel portable non-powered suction device: worldwide results

Background- Death by choking remains a significant cause of morbidity and mortality in the pediatric population, with a choking-related death occurring every 5 days. The swallowing mechanism is not fully developed in children under 2 years old, which increases the choking risk. Disorders that increase choking risk in the pediatric population include cerebral palsy, autism, Down syndrome, and other chromosomal abnormalities. Brain damage due to oxygen deprivation occurs in 7 minutes. Standard rescue protocol involves the use of back blows and chest thrusts in infants, and abdominal thrusts in children, but what happens when they fail? Readily available suction devices and instruments (Magill forceps) are invasive or require advanced medical training. The Lifevac has been in development for almost a decade (Figure 1). This device consists of a plunger with a patented one-way valve attached to a standard face mask. When the plunger is depressed air goes out the sides and not into the victim. When the plunger is pulled back suction is applied, removing foreign objects (Figure 2). The portable, non-powered, non-invasive device is simple to use, making it an attractive resuscitative device. This report summarizes the real-world results of Lifevac use on pediatric subjects in choking emergencies.

Methods- The Lifevac has been distributed worldwide over the past five years to care homes, restaurants, schools, and to individuals for at-home use. Each Lifevac kit includes written directions that should be reviewed prior to use, access to an instructional video, and a feedback form that solicits user experience reports. This report represents a summary of user experience with the Lifevac in the pediatric population after standard protocols failed.

Results- A total of 16 reports of the use of the Lifevac were submitted over the past five years. Mean age of the victims was 3.3 years old (range: 11 months – 13 years). Underlying medical conditions included Down syndrome (n=1), duplication of chromosome 15 (n=1) Sotos syndrome (n=1); the remaining victims were otherwise healthy. Obstructing objects included coins, popcorn, fruit, mucus, tuna, ham, peanut butter and bread, candy, plastic, hot dog, and carrots. Parents used the device in 15/16 cases; a staff member rescued the remaining child. The foreign body was removed in all cases and there were no serious reported side effects. To date there have been no reports of failure of the device.

Conclusions- An easy-to-use device that requires minimal training, the Lifevac has proven to be safe and effective in real-life scenarios, and warrants further investigation in the resuscitation of pediatric choking victims when standard rescue protocols fail.