Similar narrow definitions of mechanical asphyxia have occurred in Azmaks 2006 literature review of asphyxial deaths and Oehmichen and Auers 2005 book on forensic neuropathology. According to DiMaio and DiMaio, mechanical asphyxia encompasses positional asphyxia, traumatic asphyxia, and "human pile" deaths.In Shkrum and Ramsays 2007 textbook on forensic pathology, mechanical asphyxia occurs when any mechanical means cause interference with the exchange of oxygen and carbon dioxide in the body. Similar broad definitions of mechanical asphyxia have occurred in Saukko and Knights 2004 book on asphyxia, and Dolinak and Matshes 2005 book on forensic pathology. According to Shkrum and Ramsay, mechanical asphyxia encompasses smothering, choking, positional asphyxia, traumatic asphyxia, wedging, strangulation and drowning.Sauvageau and Boghossian propose in 2010 that mechanical asphyxia should be officially defined as caused by "restriction of respiratory movements, either by the position of the body or by external chest compression", thus encompassing only positional asphyxia and traumatic asphyxia.First aid
If there are symptoms of mechanical asphyxia, it is necessary to call an Emergency Medical Services. In some countries, such as the US, there may also be self-acting groups of voluntary first responders who have been trained in first aid. In case of mechanical asphyxia, first aid can be provided on your own. In such a situation, you need to do the following:

Stand behind the affected person and wrap your arms around him/her. Push inwards and upwards under the ribs with a sudden movement by your second hand.
Tolvaptan, sold under the brand name Samsca among others, is an aquaretic drug that functions as a selective, competitive vasopressin receptor 2 (V2) antagonist used to treat hyponatremia (low blood sodium levels) associated with congestive heart failure, cirrhosis, and the syndrome of inappropriate antidiuretic hormone (SIADH). Tolvaptan was approved by the U.S. Food and Drug Administration (FDA) on May 19, 2009, and is sold by Otsuka Pharmaceutical Co. under the trade name Samsca. Tolvaptan, as Jynarque, was granted approval for medical use in the United States in April 2018.The U.S. Food and Drug Administration (FDA) granted tolvaptan a fast track designation for clinical trials investigating its use for the treatment of polycystic kidney disease. The FDA granted Jynarque an orphan drug designation in April 2012, for the treatment of autosomal dominant polycystic kidney disease.Tolvaptan is available as a generic medication. Medical uses
Tolvaptan (Samsca) is indicated for the treatment of clinically significant hypervolemic and euvolemic hyponatremia.Tolvaptan (Jynarque) is indicated to slow kidney function decline in adults at risk of rapidly progressing autosomal dominant polycystic kidney disease (ADPKD).Tolvaptan phosphate is a prodrug of tolvaptan, developed for intravenous administration. Tolvaptan phosphate is converted into the active drug tolvaptan in the human body following administration. Side effects
The FDA has determined that tolvaptan should not be used for longer than 30 days and should not be used in patients with underlying liver disease because it can cause liver injury, potentially leading to liver failure.