RCUK’s position on the use of suction-based airway clearance devices on choking victims

Several suction-based airway clearance devices for the treatment of choking are now available in the UK. We do not currently support their use, as there is insufficient research and evidence on the safety or effectiveness of these devices. We are concerned that the use of these devices could delay established treatments for choking. Appropriately trained healthcare professionals can already use advanced techniques such as suction or laryngoscopy and forceps for the removal of foreign body airway obstructions.

Background
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 (ERC) and Resuscitation Council UK (RCUK) guidelines. Read our guidelines for chocking in adults and children.

Recommendation
Our recommendations focus on encouraging the conscious person to cough. If coughing becomes ineffective, give back blows and abdominal thrusts for adults/children, and chest thrusts if they are an infant.

If the person becomes unconscious, CPR should be started without delay. Avoid inserting anything into the mouth in an attempt to remove a foreign body, as it may inadvertently drive it further into the airway.

These steps are easy to learn and can be initiated promptly and effectively without the requirement for any equipment.  

Resuscitation Council UK highlights the need for further research on the safety and clinical effectiveness of suction-based airway clearance devices.

Review
Resuscitation Council UK has reviewed this statement in light of the ILCOR systematic review on removal of foreign body airway obstruction (April 2021) Removal of foreign body airway obstruction (BLS 368): Systematic Review (ilcor.org) and the ILCOR 2022 Evidence Update. No new evidence was identified to alter ILCOR’s or RCUK position on suction-based airway clearance devices. RCUK recommendations therefore remain unchanged. 

RCUK welcomes ILCOR’s call for high-quality clinical research focused on assessing the potential benefits and harms of suction-based airway clearance devices.


Reviewed and updated July 2022
Reviewed and updated September 2021