
Dechoker medical device could end deaths by choking - alvinktai
http://insiderlouisville.com/startups/cool-stuff/game-changer-dechoker-medical-device-end-deaths-choking/
======
claar
A comment on the article mentions a competitor at
[http://lifevac.net](http://lifevac.net):

"There is another version of this type of device that has been around (FDA
approved) for a couple of years now. It's called LifeVac and it has been
adopted by several fire departments, schools, skilled nursing facilities and
families all across the eastern seaboard as well Europe and Canada. Only costs
$69.95 and even that number can come down with different promotions that are
offered."

~~~
knodi123
Are you saying the article was lying? "There is nothing like Dechoker on the
market." ;-)

Looks like the earliest mention I can find of LifeVac is May 15, 2014, while
Dechoker is from 2011. I wonder if this is a case of "imitation is the
sincerest form of flattery", or whether they were independent ideas?

------
gingerlime
My wife is Japanese, and she said that in Japan lots of old people choke on
mochi (a sticky sweet made from rice). From what she says, when this happens -
the best thing to use is a vacuum cleaner. I also remember a scene from
Tampopo[0] where this takes place. Sounds pretty scary and odd, but probably
not an entire myth[1,2]

I wonder how effective this is, and what are the risks to the lungs after
whatever's stuck gets dislodged.

I guess when you're choking, you'd take that risk if all else fails (if you or
someone around you can act fast enough to pull a vacuum cleaner...)

[0]
[http://www.imdb.com/title/tt0092048/](http://www.imdb.com/title/tt0092048/)

[1] [http://www.accessj.com/2012/01/choking-on-mochi-grab-
vacuum....](http://www.accessj.com/2012/01/choking-on-mochi-grab-vacuum.html)

[2]
[http://www.japantimes.co.jp/news/2001/01/07/national/daughte...](http://www.japantimes.co.jp/news/2001/01/07/national/daughter-
uses-vacuum-cleaner-to-save-dads-life/#.ViqRL2crKAk)

~~~
alvinktai
Nice, I've never heard of this "dechoking" method. I'm guessing you need one
of these types of vacuums:
[http://www.tipa.eu/fotocache/bigorig/08850298.jpg](http://www.tipa.eu/fotocache/bigorig/08850298.jpg)
and then you put your mouth around it?

~~~
gingerlime
I guess it won't exactly work with a "standing" vacuum cleaner(like [0]), but
in recent years, most vacuum cleaners I see -- like the one you linked to --
have a long hose, and you can definitely fit it in someone's mouth. (you
remove the big attachment at the end)

On the cost side, you can probably get a nice vacuum cleaner for $150 :)

I'm still wondering about how effective vs. how risky this technique might be
though

[0] [http://www.amazon.com/Rowenta-Lightweight-Cordless-
Cyclonic-...](http://www.amazon.com/Rowenta-Lightweight-Cordless-Cyclonic-
Functions/dp/B007X6B1HU/ref=br_lf_m_cfkfghes52vm7w3_1_1_ttl/186-4649770-3613910?ie=UTF8&s=home-
garden)

------
lazyant
> the instructor told him frankly that the victim would die. He researched the
> subject thoroughly and found that there was absolutely no other solution to
> choking besides the Heimlich maneuver

maybe I've seen too many movies, but what about the old knife and ball pen
Tracheotomy?

~~~
Johnny555
Father Mulcahay certainly had no trouble performing one with no medical
training, just a doctor on a radio to walk him through it. Must be pretty
easy.

~~~
brianberns
That was a great episode.

------
gwern
Some googling
([https://scholar.google.com/scholar?as_ylo=2011&q=dechoker&hl...](https://scholar.google.com/scholar?as_ylo=2011&q=dechoker&hl=en&as_sdt=0,21))
suggests there are no trials on the Dechoker yet. While that makes sense
(realistic choking must be hard to induce experimentally, and any sort of
experiment in the wild suffers from choking being rare), it does make me
wonder how well it works.

~~~
dx211
It seems like if they don't have enough pressure in their lungs to expel the
bite of ham sandwich, you wouldn't necessarily be able to suck it out with
this device. On the other hand, I have a hard time blowing up those skinny
balloons for balloon animals, but the pump thing they sell with them does it
like a champ.

~~~
Corrado
I doubt that you can completely deflate your lungs by exhaling; even if you
try your hardest to exhale as deeply as you can. There would always be some
air in the lungs so that the pressure difference generated by this device
would almost certainly be enough to pop the blockage out of your trachea.

~~~
jxramos
That's exactly right, something called Residual Volume
([https://en.wikipedia.org/wiki/Lung_volumes#Values](https://en.wikipedia.org/wiki/Lung_volumes#Values))

------
deltaecho1338
Please note the small text on this page that says: "There is no guarantee this
device will remove debris from the airway."

[http://www.dechoker.com/pages/dechoker-usage-
instructions](http://www.dechoker.com/pages/dechoker-usage-instructions)

It is a 510K-exempt Class I medical device, according to the FDA. So its
manufacturer has registered with the FDA but there is no FDA approval of its
claim of being able to dislodge objects from a patient's airway. Nor is any
data provided to demonstrate that it is at all effective.

~~~
userbinator
_There is no guarantee this device will remove debris from the airway._

That's somewhat of a "duh!" but I guess it's there just for legal reasons.

------
noomerikal
I just had a CPR class this week (baby due 11/30) and was thinking along these
lines - isn't there another way.

Side note for some of the other comments - there are multiple ways to apply
pressure to the thoracic cavity in order to express something lodged in the
throat. If the person is large and you cannot wrap your arms around them, have
them stand with their back against the wall and you thrust from the front just
below the diaphram.

The goal of CPR is to resuscitate an individual who is not breathing. Whether
the individual sustains other injuries through the course of being
resuscitated does not matter. Better to be alive and injured than dead!

~~~
ihsw
Indeed, you would be surprised by how often individuals suffer minor rib
damage while being resuscitated.

------
mhb
It's a clever idea, but is the vision for this to have one hanging on the wall
in a vast number of public places? It says there are 160,000 choking deaths
worldwide annually. Presumably the Heimlich maneuver would have worked on some
number of those. What is the marginal number of lives saved and at what cost?

~~~
nsgi
The Heimlich manoeuvre worked on none of them, because they died. It might
have been possible to prevent some of those deaths with wider or more
effective provision, but that would also have costs.

~~~
chrisfosterelli
Just because they died doesn't mean someone:

1) Did the Heimlich manoeuvre

2) Performed it properly

3) Continued proper behaviour after the Heimlich manoeuvre failed

There is a good chance the people who died were alone, that everyone around
them panicked and froze up, or that nobody realized the person was in danger
(people who choke are actually more likely to leave the room than try to tell
someone). People often don't call 911 until it's too late.

I do see the OP's point that potentially education and teaching of what to
actually do in these scenarios would be more effective than buying a vast
number of these devices. I took a first aid course and I can say that while
the majority of people _know_ what the Heimlich manoeuvre is, I don't believe
they'd behave properly in a chocking situation.

That said, I think these should _definitely_ be put to trial runs to find out
:)

~~~
nsgi
My point is that I don't think that's a problem that can be solved with a few
posters. It doesn't matter if the deaths could have technically been prevented
with the Heimlich manoeuvre unless there's a cheap and practical way to get
people to perform it properly.

~~~
mhb
So you think a problem that can't be solved with a picture of someone helping
someone choking by grabbing them from behind and squeezing can be solved by
having them find this gadget and figuring out how to use it? Curious.

------
readme
I saw someone die by choking when I used to work in a restaurant. This device
would have been helpful. It also would've been helpful if anyone did anything
right in an emergency.

There were 3 hostesses standing next to the phone. I was the bus boy.

After a manager told me to go all the way to the back and get another manager,
I told him we should probably call 911 first.

The fire dept was across the street.

When I walked up to the phone, none of the hostesses had called 911, because
no one told them to.

I called 911, but it was too late.

The man died.

~~~
swombat
That sounds awful. I'm sorry you had to be a party to such an event. Even if
there were all these other older and more experienced people who should have
acted intelligently, it sounds like you're still feeling guilty that you
didn't do better. It's hard to realise that in most situations you do have to
trust that in your instincts, instead of being able to think that all these
supposedly more senior and responsible people actually have a clue... It
shakes your faith in people and your sense of security. I'm sad that you had
to go through that.

------
wanderfowl
I love the idea, and it's just the kind of thing I'm paranoid enough to own,
but the price is a bit up there. Hoping it comes down over time. But if I
owned a restaurant, I'd be all over this, in a "Break Glass" kind of case.

~~~
mfoy_
That's the idea the article conveys, one of these should be next to every
defibrillator (and defibs are seen in so many locations).

~~~
Consultant32452
Not every restaurant has a defibrillator, but every restaurant may want one of
these if it's really that effective.

~~~
encoderer
And they should have it in the bathroom!

I've heard from an EMT friend that most choking deaths happen in restaurant
bathrooms. Somebody gets up to excuse themselves to be polite and dies alone
beside the dyson hand dryers.

~~~
alvinktai
I know if I were choking, I don't know how polite I would be to everyone
around me

~~~
Consultant32452
As a person with a medical condition that causes me to choke more often than a
normal person would, I usually excuse myself because rectifying the situation
typically involves vomiting.

------
dheera
I read it as

    
    
        (Dechoker medical device could end deaths) by choking
    

when it really should be

    
    
        Dechoker medical device could end (deaths by choking)
    

English really needs better syntax.

~~~
adimitrov
This is known as an attachment ambiguity. The classical sentence is "The man
saw the woman with the telescope."

I'm afraid it is not limited to English, and a very common phenomenon across
many languages that use prepositional phrases. Languages that do avoid these
usually have a complicated case system. Even there, we have other ambiguity-
types that are also common in English, such as relative clauses, quantifiers,
etc.

Ambiguity is a natural part of languages. It can be fun :-)
[http://languagelog.ldc.upenn.edu/nll/?p=4566](http://languagelog.ldc.upenn.edu/nll/?p=4566)

~~~
thaumasiotes
My favorite standard example sentence (of ambiguity, that is) is "we saw her
duck".

~~~
eru
Time flies like an arrow, but fruit flies like a banana.

~~~
fenomas
Yesterday I shot an elephant in my pajamas. How he got in my pajamas, I'll
never know.

------
silveira
My brother once chocked with a piece of barbecue meat with farofa (a Brazilian
mix of toasted cassava flour) in a restaurant. He was barely breathing, and
could not swallow anything. We rushed to the hospital and they were able to
save him.

Nobody new how to perform a Heimlich maneuver, and I don't know if it would
have worked. I wonder if this device would have the suction strength to pull
the obstruction in that situation, probably yes.

~~~
flatline
I took a CPR class several years ago before our first kid was born and within
a week I couldn't have told you 100% how to perform a Heimlich. You drill it a
couple times and are somehow expected to be able to perform it in an
emergency, months (or in my case with a one-off class, years) later. I would
attempt it if someone was choking with nobody better qualified around, but I
always doubt that many people are going to be effective with this maneuver. I
also couldn't imagine me doing much of anything on someone 200+ pounds (I'm
all of 155). I'm really glad to hear there's an alternative.

~~~
andrewaylett
That's one reason I really appreciate being a first-aider at work -- I get
paid to do refreshers every year or two. The repeat classes usually contain at
least one bit of information I've not heard before, but the biggest benefit is
the opportunity to practise the techniques I've not had to use all year.

I took the full 3-day course for the first time this year, and the extra time
for practicals was excellent.

------
datashovel
I'm curious to know the actual numbers (ie. force a human body can exert when
attempting to breath in vs opposite pressure caused by this device or
heimlich).

I performed heimlich on a roommate a long time ago when I was in college, but
it turns out the pressure he was breathing in with was apparently more than
the force I exerted trying to get him to push the object out. I simply helped
dislodge the object, but it ended up going into his lungs rather than out.

Afterwards he told us he could feel the food (what was obstructing airway) in
his lung.

~~~
omarchowdhury
And what happened after that?

~~~
datashovel
He was fine as far as we all knew. He ended up leaving to go back home a few
months after, and I wasn't close so we didn't stay in touch. I can't give a
long-term prognosis, but I imagine the human body probably has mechanisms to
deal with that sort of thing.

He didn't feel concerned enough about it to go to the hospital afterwards, and
we were just college students so we didn't feel we had any reason to override
his decision.

~~~
vacri
For future reference, go to hospital. The lungs are a one-way system and can't
digest things - any object going in either comes out the same way or sits
around. That lump of food will have rotted, and would be a significant
infection risk.

~~~
datashovel
Good to know. And btw, just in case anyone reading would get the wrong
impression from my previous comment, I'm not saying I think the lungs could
technically digest food.

Basically, in my experience, if I've ever inhaled water (never food) I
generally find that there's several minutes (or hours depending on quantity of
fluids) of intermittent coughing where I feel like my body is doing something
to make it easier for me to expel the fluids.

In terms of food, depending on quantity I was imaginging over course of
several days (weeks?) perhaps the body is able to expel the solids in similar
fashion.

My roommate was not a very talkative person, but we did hang out quite a bit
while he lived with us, and nothing ever appeared abnormal, and he never got
sick so I'm guessing he just kept the messy details to himself.

------
vacri
> _He researched the subject thoroughly and found that there was absolutely no
> other solution to choking besides the Heimlich maneuver. So he spent the
> past five years developing new technology to solve this problem._

Strange, I did my last first aid course about 5 years ago, and remember a few
methods other than the Heimlich. The Heimlich has this weird PR where it seems
that it's the only method that the US knows about. It's a bad method because
it's not very good at applying pressure in the right places, and done by
enthusiastic naifs it can break ribs (less of a problem) and do serious damage
to internal organs (more of a problem).

Three alternatives to the 'one and only' Heimlich:

1) Start with short, hard, upward slaps on the victim's back, with the victim
bent over if possible. This is more helpful in cases of partial choking

2) Get the victim on the ground on their side, and using both hands, push down
on the side of their ribcage in short, sharp bursts. This uses the same 'pop a
cork' mechanism as the Heimlich, but you get a lot more power and you won't
damage internal organs (and are unlikely to break bones).

3) As a last resort, try and blow the obstruction further into the lungs. It
will require surgery to remove, but that's better than dying.

~~~
mhb
What is your source for #2? The NHS (i.e., not the US) doesn't mention that
technique.

[http://www.nhs.uk/chq/pages/2301.aspx?categoryid=72](http://www.nhs.uk/chq/pages/2301.aspx?categoryid=72)

~~~
vacri
St John's Ambulance does first aid training here in Melbourne. They're
basically a volunteer group who work alongside the professional paramedics; St
John's generally does events like concerts and festivals, while the
professionals do the usual emergency stuff. St John's also do a lot of first
aid training here (the above examples come from a course of theirs).

The side chest compressions tend not to break ribs - normal CPR compressions
do, but CPR needs to squish the heart - a smaller, tougher organ than the
lungs. The heimlich also has to be done in an upright position, which makes it
more awkward to do if you're not physically strong; it's all bicep strength,
and you can't use your own weight to your advantage. Chest thrusts are also
not complicated by a patient who is obese or pregnant.

Just googling around, found some research arguing for (normal) chest
compressions over heimlich, from 2000:
[http://www.ncbi.nlm.nih.gov/pubmed/10767497](http://www.ncbi.nlm.nih.gov/pubmed/10767497)

~~~
mhb
That all seems reasonable. It's just that your post is the first place I've
ever heard of this technique of pushing on a choking person's side. Since it
came packaged with snark about the US Heimlich PR I expected to find a lot
more information and advocacy for it. Meanwhile the best you can do is provide
a link to using normal chest compressions - not applying side compressions as
you mentioned.

------
aroch
Isn't applying negative pressure to the lung also a great way to collapse it?

~~~
lungthrowa
If this thing can apply negative pressure to a lung, the airway isn't totally
obstructed.

~~~
dragonwriter
> If this thing can apply negative pressure to a lung, the airway isn't
> totally obstructed.

Conversely, the instant this thing succeed in dislodging an obstruction, it
will apply negative pressure to a lung (or, really, two of them.)

------
raisedbyninjas
Wow, it seems so obvious now.

~~~
ph0rque
That's a hallmark of a great idea.

------
mikeash
Simple and smart. I like it and wonder if I should buy one. Seems like cheap
insurance.

I wonder, does it work on people with beards? I know this usually causes
trouble with sealing masks like this. Even if it doesn't, it's still a really
useful device for all the non-bearded people out there, but I have to wonder.

~~~
learc83
I have a beard, and that's the first thing I thought of. I would guess that
it's designed to be pretty forgiving, i.e., no needing a perfect seal.

I'm assuming the company knows the answer to this, I think I'll send them an
email.

~~~
chazu
BRB shaving my face.

~~~
TomStephenson
I found this on their site
[https://vimeo.com/user31799477/review/143372612/72fa68229b](https://vimeo.com/user31799477/review/143372612/72fa68229b)

Also, it seem all you have to do for a beard is apply a little more pressure
to form that seal

------
nsxwolf
My mother choked on a piece of steak in a restaurant when I was a child. I
didn't know what was going on. She was completely silent.

Someone gave her the Heimlich maneuver and it worked. Good thing to learn.

------
ecaron
For $150, it seems very overpriced to me. I expected this to be in the $30
range.

Am I missing some profound piece of engineering that warrants this price? Or
is more of a "I think I can charge $X and make s 9x profit" move (which I
don't fundamental object to.)

~~~
bsder
> Am I missing some profound piece of engineering that warrants this price?

Liability insurance and FDA approval. If you've ever seen the words "For
Research Purposes Only" on equipment, that's an indication of profitable
device, but small market.

I know people who sell equipment to IVF (in-vitro fertilization) labs that are
_insane_ about safety, so their equipment is certainly good enough for general
use. However, their volume is sufficiently low that it's just not worth the
monetary expenditure given that they have an out simply by labelling things
correctly.

~~~
alvinktai
Agreed. Developing a medical device is not cheap and unlike most consumer
products, these devices need to go through rigorous safety testing to make
sure it does what it says it does. A lot of capital is needed just to comply
with FDA regulations.

