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Report LifeVac Usage

Incident Details

Date of Choking Incident

City where the choking incident took place

State where the choking incident took place

Patient Male or Female?

Male

Female

BLS Protocol first followed? (ex. back blows, abdominal thrusts)

Yes

No

Was patient conscious a time of device use? (LifeVac)

Yes

No

Hazard successfully dislodged with LifeVac?

Yes

No

Did patient receive medical examination afterwards due to BLS being performed

Yes

No

Submit

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We will contact you soon. A copy of this will be sent to your email address.

Reference ID:

1-877-LIFEVAC

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MHRA Registered
Registered in Australia ARTG Number 285082
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Incident Details

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1-877-LIFEVAC

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