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Safety Services March 2017

S AFETY NEWS
Anti Choking Devices

In order to support schools, further clarification on the use of anti choking devices, including the
Life Vac, has been obtained.

You may have been approached by a charity offering you such a device free of charge, or have had
sales information regarding these devices.

The principle behind the device is that it is a non-powered, suction device, which has been developed
to support with dislodging food or objects once all first aid training techniques have been tried without
success.

As in a previous email, the council does not endorse this product.

Since our last correspondence, further guidance has been obtained through the Councils Public Health
team, in partnership with Hull and East Yorkshire Hospitals (HEY), who have comprehensively
reviewed the use of such devices particularly in a paediatric context.

It is recommended at this time that the device is not used


until further evidence on suitability for paediatric use is published.

In order to give you the context and basis for this recommendation and help you in making a decision
as to whether to have one at your site, these are the main findings:

Medical

The devices use is not currently recommended in existing International Liaison Committee
Guidelines on Resuscitation (and therefore not in UK Resus Council Guidelines)

There are no clinical trials to support the devices use

The only trial to date has been on a non-living adult (ie. an unrealistic scenario)

Successful use of the device has been reported however these examples only involve adults
(anatomically very different to children) with known neurological conditions, which make
them more prone to choking. The nature of the cause of the choking is therefore known. The
difference with children is the foreign body they may be choking on itself- children are more
likely to choke on solid food or small toy objects.

If the obstruction is in the trachea, the device would simply empty the stomach rather than
remove the obstruction, which could make the situation worse.
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Training

During their research, representatives from HEY attended the device training.

Concerns were raised that the device company representative was unable to demonstrate a number of crucial
elements required for safe and effective use, including how to correctly size a facemask. The wrong size of
facemask would lead to an inadequate seal, and subsequently be ineffective.

Neither of the HEY representatives, both of whom have extensive experience in managing airways, were able
to successfully clear the obstruction on the LifeVac mannequin used in the training.

Reputable Use and Endorsement

The anti choking devices are not currently used by the British Red Cross; the Yorkshire Ambulance Service or
Hull and East Yorkshire Hospital Trust.

They are much more widely recognised in America.

They are not included on recognised training courses. Training is available through the company only.

Advice

Until further clinical research on the safe use of this device on children,
the use of anti choking devices is not recommended.

The advice from medical professionals is therefore that staff should be trained in standard guidelines for the
management of a choking child. This is covered by approved first aid training course providers.

To reiterate previous advice:

Ensure you have considered first aid training provision and have in place an adequate number of
people, with appropriate training including paediatric and emergency first aid at work.
Consult with staff to ensure that they are happy with the supervisory and first aid arrangements they
may have ideas as to how they can be improved;
Ensure that all staff are aware of procedures and their role;
Ensure that you have in place a first aid coordinator whose role is to ensure that first aid provision is
maintained;
Having records of, and regularly reviewing, first aid treatment administered and incident history is
also good practice to ensure that you can review your procedures and provision accordingly.