RCUK’s policy on the use of airway clearance devices on choking victims

The scientific evidence for the treatment of choking was first reviewed by the International Liaison Committee on Resuscitation (ILCOR) in 2005, and subsequently reviewed by the European Resuscitation Council in 2010 and 2015. This evidence supports the Resuscitation Council UK 2015 guidelines for choking. You can read our guidelines for choking in adults here, or for children here. 

Our recommendations focus on encouraging the conscious victim to cough, followed by back slaps and abdominal thrusts (or chest thrusts if the victim is a child) if coughing is ineffective. If the victim becomes unconscious, CPR should be started without delay. These steps are easy to learn and can be initiated promptly and effectively without the requirement for any equipment.  

Bystanders should avoid inserting anything into the mouth in an attempt to remove any foreign body as it may inadvertently drive it further into the airway. 

Resuscitation Council UK is aware that several airway clearing devices for the treatment of choking are now available in the UK. There is insufficient evidence on the safety or effectiveness of these devices for us to recommend their use, and we are concerned that the use of these devices could delay established treatments for choking; for this reason, Resuscitation Council UK does not support their use. 

Appropriately trained healthcare professionals can already use advanced techniques such as suction or laryngoscopy and forceps for airway foreign body removal. We recommend that new airway clearance devices should only be used by trained healthcare professionals as part of a formal evaluation.