Arthur Lih of Massapequa sold his first LifeVac to a fire department about 18 months ago, when the Jericho Fire Department purchased 21 of the devices.

Now about 10 Long Island fire departments have purchased Lih’s invention, which is designed to suction foreign objects from the throats of choking victims when procedures such as the Heimlich maneuver don’t work.

He has sold about 5,000 LifeVacs in the United States and abroad since the device went on the market in August 2014.

The sales have only come after long days of pitching the product to schools, fire departments, police departments, government officials and restaurants.

Fire departments are a sweet spot for LifeVac, Lih said, because the Long Island volunteers are often the first responders at an emergency. But it’s difficult to get into all the departments because of the fragmented system in Nassau and Suffolk counties. There are 131 fire districts on Long Island, according to the state comptroller’s office.

“It’s very difficult, because it’s a one-by-one process,” said Lih, 52, who previously co-owned a freight company. “It usually takes two or three meetings, and each meeting can take 30 to 45 minutes, so it’s definitely time consuming.”

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The Freeport Fire Department is one of Lih’s clients. It bought about 25 LifeVac devices to put on trucks, as well as in chiefs’ vehicles, said Ray Maguire, the department’s executive director.

“It’s an extra tool in the toolbox,” Maguire said. “I’d be surprised if anyone who sees it doesn’t purchase it. It’s that tool you may only need once, but it’s the tool you really want in case you need it. It’s affordable. I have it in my car. I have one at home, too.”

The plunger-like device sells for $69.95; there is a discount on bulk sales.

Maguire said it could take a while for Lih to get the LifeVac into more Long Island fire departments because the system is so Balkanized.

“The fire departments out here are volunteer; you’re not going to get in front of all the departments in one group,” Maguire said. “Each one is autonomous and that includes being in charge of their own finances.”

But small startups such as LifeVac could speak at conventions or to trade groups in order to get the message out, even if it’s a fragmented market, said Thomas W. Shinick, a professor of marketing and management at Adelphi University.

“No matter what, they all have various conferences, trade groups and publications,” Shinick said. “You can apply to speak at a convention. Also, with social media, it’s become easier to get the message out.”

Small businesses could also lean on YouTube videos to market their products, said Richard Hayes, an associate professor of management and entrepreneurship at Hofstra.

Lih said he has a few videos on YouTube, and he has spoken to regional meetings of fire chiefs, but it’s still time-consuming.

“I’m funding this, so I have a limited budget for advertising, marketing and travel,” he said. Lih said he has invested about $240,000 of his own money in the company, and another investor has put $120,000 toward the venture.

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Lih is competing with Dechoker, a North Carolina-based maker of a similar product.

Dr. Lee Smith, chief of the division of pediatric otolaryngology at Northwell Health, said he has not heard of either product. But he said that if a choking victim can’t breathe, he or she becomes a candidate for the Heimlich. If the Heimlich doesn’t work, the victim would probably lose consciousness because of a lack of oxygen.

“At that point, there would be a combination of rescue breathing and trying the Heimlich again,” Smith said, adding that a finger sweep would also be performed to try and remove the object.

A challenge for any new medical device is convincing potential users that it works and is safe. In tests, the LifeVac successfully removed an obstruction from the throat of a cadaver on the first try 49 out of 50 times, according to an August research article in the American Journal of Emergency Medicine.

But Dr. David S. Kugler, associate medical director of the Center for Emergency Medical Services at Northwell Health, said a test on a cadaver won’t prove the LifeVac is effective.

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“The cadaver itself is not always like a live person, especially if the tissue is frozen or swollen,” Kugler said. “The anatomy is the same, but these things can impede a true response on the device.”

Lih invented the product in his garage, inspired after he went with a friend to a hospital while the friend’s mother was going through tests.

“He pointed across the room and said the last time he was there, a 7-year-old child had choked to death on a grape,” Lih said. “He mentioned that the mom was wailing. My daughter was 7 at the time and I couldn’t let that happen to her.”

About 4,800 people died from choking in 2014, according to the latest statistics from the National Safety Council.

“If the LifeVac saves a life, it’s worth it,” Lih said.

Lih brought his prototype to Stewart Swiss, who owns Edgewood-based manufacturer Aztec Tool Co.

“It took us about three months to get this to where we are now,” Swiss said. “We had to go from design to design, but that’s what we do. That’s a normal product development cycle.”

Now, Aztec manufactures about 500 LifeVacs a month. Lih said he sold 400 devices in November, bringing in about $20,000.