Cari genitori
Mi giungono varie richieste su dispositivi da utilizzare in caso di soffocamento da coroo estraneo.
La risposta sintetica è "Non risultano studi clinici di efficacia ma, anche se esistessero, le manovre salvavita si debbono imparare a “mani nude”.
Non distogliamo l’attenzione da questo. CHE E’ FONDAMENTALE. Qui sotto un video dimostrativo.
Ci sono molti punti deboli nei dati disponibili e pochi studi imparziali che mettono alla prova l’efficacia dei dispositivi di aspirazione anti-soffocamento, con conseguenti prove insufficienti per supportarne, ma anche a scoraggiarne, l’uso.
E' certo e sicuro che si debbono seguire le raccomandazioni delle linee guida redatte dalle autorità locali ed internazionali.
Comunque se qualcuno lo volesse comprare, o lo avesse comprato, bisogna ricordare, come dicono gli stessi produttori che: "i dispositivi siano stati ideati per essere utilizzati qualora le manovre standard raccomandate non siano applicabili o non abbiano dato risultati soddisfacenti".
Anche il dr. Henry Heimlich, inventore della manovra salvavita che ha preso il suo nome, si espresse in passato affermando che nessuna “macchina” avrebbe mai potuto eguagliare l’efficacia di un essere umano che intervienga praticando la manovra manuale.
E' stato anche scritto che ogni azione che ritardi l’utilizzo della manovra di Heimlich o che rischi di complicare la situazione del paziente potrebbe risultare fatale.
Anche il presidente dell’American College of Emergency Physician, Jay Kaplan, appare scettico in merito all’efficacia del dispositivo meccanico, ritenendo molto difficile riuscire a posizionare la mascherina ad un paziente in stato di panico e distress respiratorio derivanti da una situazione di soffocamento.
I rappresentanti di alcuni di questi dispositivi hanno spiegato che i dispositivi siano stati ideati per essere utilizzati qualora le manovre standard raccomandate non siano applicabili o non abbiano dato risultati soddisfacenti.
Le conclusioni di questa pubblicazione (Pediatrics): https://publications.aap.org/pediatrics/article/147/3_MeetingAbstract/412/5281/Resuscitation-Of-Pediatric-Choking-Victims-Using
“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.”. SOTTOLINEO: QUANDO I PROTOCOLLI STANDARD DI RIANIMAZIONE FALLISCONO.
SU PUBMED si trovano pubblicazioni: 3 fatte su cadaveri, 1 su manichini.
Trovate qui sotto:
Assessment of the LifeVac, an anti-choking device, on a human cadaver with complete airway obstruction.
Juliano M, Domingo R, Mooney MS, Trupiano A.
Am J Emerg Med. 2016 Aug;34(8):1673-4. doi: 10.1016/j.ajem.2016.03.047. Epub 2016 Mar 23.
PMID: 27260557 No abstract available.
Phase One of a Global Evaluation of Suction-Based Airway Clearance Devices in Foreign Body Airway Obstructions: A Retrospective Descriptive Analysis.
Dunne CL, Osman S, Viguers K, Queiroga AC, Szpilman D, Peden AE.
Int J Environ Res Public Health. 2022 Mar 24;19(7):3846. doi: 10.3390/ijerph19073846.
PMID: 35409529 Free PMC article.
Researchers performed data extraction using a standardized form which included patient, situational, and outcome variables. Results: The analysis included 124 non-invasive (LifeVac) and 61 minimally invasive (Dechoker) ACD interventions. Median patient age was 40 (LifeV …
Would anti-choking devices be correctly and quickly managed by health science students? A manikin crossover trial.
Cardalda-Serantes B, Carballo-Fazanes A, Rodríguez-Ruiz E, Abelairas-Gómez C, Rodríguez-Núñez A.
BMC Med Educ. 2023 May 23;23(1):365. doi: 10.1186/s12909-023-04345-7.
PMID: 37221498 Free PMC article.
BACKGROUND: The brand-new anti-choking devices (LifeVac and DeCHOKER) have been recently developed to treat Foreign Body Airway Obstruction (FBAO). ...Therefore, this study aimed to assess the ability to use the LifeVac and DeCHOKER devices in an adult FBAO simulate …
A systematic review on the effectiveness of anti-choking suction devices and identification of research gaps.
Dunne CL, Peden AE, Queiroga AC, Gomez Gonzalez C, Valesco B, Szpilman D.
Resuscitation. 2020 Aug;153:219-226. doi: 10.1016/j.resuscitation.2020.02.021. Epub 2020 Feb 27.
PMID: 32114068 Review.
Although several devices have been manufactured worldwide, the LifeVac has been most extensively studied, with a combined dislodgement success rate of 94.3% on first attempt. ...
Use of a Novel Portable Non-powered Suction Device in Patients With Oropharyngeal Dysphagia During a Choking Emergency.
McKinley MJ, Deede J, Markowitz B.
Front Med (Lausanne). 2022 Feb 2;8:742734. doi: 10.3389/fmed.2021.742734. eCollection 2021.
PMID: 35186960 Free PMC article.
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 oropharyng …
The efficacy and usability of suction-based airway clearance devices for foreign body airway obstruction: a manikin randomised crossover trial.
Patterson E, Tang HT, Ji C, Perkins GD, Couper K.
Resusc Plus. 2021 Jan 8;5:100067. doi: 10.1016/j.resplu.2020.100067. eCollection 2021 Mar.
PMID: 34223337 Free PMC article.
The usability of LifeVac and abdominal thrusts were generally evaluated more positively than the Dechoker. CONCLUSION: In this manikin study, we found that, compared with abdominal thrusts, the success rate for foreign body airway obstruction removal was higher in the L …
A comparative study of polyurethane and silicone cuffed-catheters in long-term home total parenteral nutrition patients.
Beau P, Matrat S.
Clin Nutr. 1999 Jun;18(3):175-7. doi: 10.1016/s0261-5614(99)80008-9.
PMID: 10451475
Mean catheter life span was 12 months (range: 0.25-47) and 13 months (range: 3-44) for Lifevac and LeaderCuff catheters, respectively. Complication rates (expressed as patient-year of TPN) were no significantly different for Lifevac and LeaderCuff catheters: sepsis
The efficacy of two commercially available devices for airway foreign body relief: A cadaver study.
Ramaswamy A, Done A, Solis R, Srikanth M, Olinde L, Belafsky P.
Laryngoscope Investig Otolaryngol. 2023 Apr 22;8(3):708-711. doi: 10.1002/lio2.1057. eCollection 2023 Jun.
PMID: 37342119 Free PMC article.
RESULTS: The DeChoker resulted in gross injury to the tongue and failed to remove the obstruction in all trials. LifeVac was successful in removing the barium-moistened saltines but failed to remove all other foreign bodies. Both devices applied significant pressure to the …
A Protocol for the Prospective Evaluation of Novel Suction-Based Airway Clearance Devices in the Treatment of Foreign Body Airway Obstructions.
Dunne CL, Queiroga C, Szpiman D, Viguers K, Osman S, Peden AE.
Cureus. 2022 Jan 4;14(1):e20918. doi: 10.7759/cureus.20918. eCollection 2022 Jan.
PMID: 35154915 Free PMC article.
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