RCUK’s policy on the use of suction-based 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 2020. This review formed the basis of current European Resuscitation Council and Resuscitation Council UK guidelines. 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 suction-based airway clearance 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 the removal of foreign body airway obstructions. Resuscitation Council UK highlights the need for further research on the safety and clinical effectiveness of suction-based airway clearance devices.

Reviewed and updated September 2021