20.500.12556/DKUM-93809 Counterfeit anti-choking suction devices: Prevalence and risks on online marketplaces To the Editor, Anti-choking suction devices represent an innovative first aid method designed to remove foreign body airway obstruction. Although they are not part of the current European Resuscitation Council guidelines,1 they are used by many healthcare professionals and laypersons.2, 3, 4 As with any medical devices, there appear to be many more affordable counterfeit and unbranded copies products on the market claiming to be anti-choking suction devices.5 In June 2024, the United Kingdom's Office for Product Safety and Standards issued a recall for counterfeit anti-choking suction devices sold through online marketplaces. It is stated that they are lacking certification marks (for example European conformity = CЄ), details of the manufacturer, unique identifiers and serial numbers on the device. There is also a possibility that they will not work and could worsen the situation by pushing obstruction further down the airway, due to their poor design and quality.6, 7 The aim of this review is to investigate the prevalence of counterfeit and unbranded anti-choking suction devices on the most widely used online marketplaces. We conducted a review using the keyword “anti-choking suction device” on the online marketplace AliExpress (AliExpress, China). The search was conducted in November 2023 and January 2025. The shipping country was set to Slovenia. We investigated the number of products found, the number of products sold and their prices. In November 2023, a total of 41 different anti-choking suction devices were identified, with an average price of €14.00 (SD ± 0.41) and over 3,324 units sold. By January 2025, the number of identified devices had increased to 59, with a higher average price of €16.27 (SD ± 26.66) and total sales exceeding 9,481 units. One of the counterfeit anti-choking suction devices was also purchased on AliExpress for €6.97. As shown in Fig. 1, the device lacked certification marks, manufacturer details, unique identifiers, and serial numbers. Fig. 1. Fig. 1 Open in a new tab An example of a counterfeit anti-choking suction device without certification marks. The results highlighted a significant increase in the number of counterfeit anti-choking suction devices sold, despite being limited to one marketplace from China. Compared to certified anti-choking suction devices on the market, counterfeit versions are three to four times cheaper, especially considering that they are single-use devices. The question arises whether consumers knowingly purchase counterfeit anti-choking suction devices to save money or if they are unaware that these devices are uncertified. Experts, however, can recognize these counterfeits by their distinct appearance, absence of labels and identifiers, lack of a valve, and incomplete instruction manuals.6, 7 Beyond the questionable characteristics of anti-choking suction devices, concerns also arise regarding variations in their working principles and the suction they generate—both critical factors for effective functionality. anti-choking suction devices emergency medicine online marketplaces innovative first aid methods airway obstruction obstrukcija dihalnih poti s zujkom zadušitev sesalna naprava proti zadušitvi true true true Elsevier B.V. Angleški jezik Slovenski jezik Znanstveno delo 2025-07-22 14:47:05 2025-07-23 08:09:47 2025-07-24 03:10:14 0000-00-00 00:00:00 2025 0 0 2 str. Letn. 22, št. članka 100899 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2025-02-04 2025-02-05 2025-02-10 2666-5204 616-083.98:615.4 230391811 10.1016/j.resplu.2025.100899 2666-5204 main_(2).pdf main_(2).pdf 1 461D721A4B753A9628E4893011FCF2E9 458597637364188580c4dbde9fa2f5f8a7ef5b59966145420f12a21b5a98f343 0d0619a2-66fa-11f0-b4a7-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=193949 https://api.elsevier.com/content/article/PII:S2666520425000360?httpAccept=text/xml 1 f8984f6c-66f9-11f0-b4a7-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=193946 https://api.elsevier.com/content/article/PII:S2666520425000360?httpAccept=text/plain 1 f89abcdc-66f9-11f0-b4a7-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=193947 Fakulteta za zdravstvene vede 0 0 0