Comparative efficacy of LifeVac® and Heimlich maneuver in simulated airway obstruction

Objectives

Foreign body airway obstruction is a significant cause of morbidity and mortality, especially in infants and young children. This study aims to compare the efficacy of the Heimlich maneuver and LifeVac® in a simulated environment.

Methods

A prospective experimental study was conducted using the Choking Charlie (Laerdal®) mannequin, which simulates the trunk from an adult male and is considered suitable for simulating choking events in young children. The study involved four operators: one Pediatric Advanced Life Support (PALS) instructor and professor of Trauma and Emergency Medicine, along with three members of the university's Pediatric Academic League, all previously trained in Basic Life Support (BLS). The primary outcome was the success rate of foreign body removal. Intracavitary pressures generated during the maneuvers were measured using a digital manometer.

Results

A total of 200 anti-choking maneuvers were performed, and both techniques successfully relieved airway obstruction in all cases. The LifeVac® device generated significantly lower intracavitary pressure differentials compared to the Heimlich maneuver (p < 0.000). Additionally, both techniques exhibited significant variability in applied pressure among different examiners (p < 0.000).

Conclusions

Both the Heimlich maneuver and LifeVac® are effective in relieving foreign body airway obstruction when performed by specialists in a simulated environment. Heimlich generated higher positive pressure gradients, while LifeVac® produced lower negative pressure gradients.