Dechoker vs. LifeVac: Choosing an Anti-Choking Device for SMA | mySMAteam

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Dechoker vs. LifeVac: Choosing an Anti-Choking Device for SMA

Posted on May 25, 2023

It’s terrifying when someone starts choking while eating, a particular risk for many people living with spinal muscular atrophy (SMA). If you or a loved one has SMA, being prepared to take lifesaving action is vital — could a device such as the Dechoker or LifeVac help?

Choking is a serious hazard for people with SMA, which can cause weakness in the muscles used for swallowing and chewing. If you’re living with SMA or the parent of a child with the condition, you may have considered buying an airway clearance device to keep at home or carry with you. Here is a rundown on the Dechoker versus LifeVac, including how they’re used, findings about their effectiveness, and the pros and cons of each.

The Dechoker

The Dechoker is a portable, handheld suction device with a one-way valve designed to keep air from going back into the airway, which would make choking worse. This device can be used for anyone 12 months of age or older and comes in different sizes for toddlers, children, and adults. Anti-choking devices can be marketed without first getting an OK from the U.S. Food and Drug Administration, so they are registered but not approved by the FDA. Dechokers are priced from about $50 to $95.

The Dechoker is a portable, handheld suction device with a one-way valve. It’s designed to keep air from going back into the airway, which would make choking worse. (CC BY 2.0/Bhanderi and Palmer Hill)

How Is It Used?

If you or your loved one is choking, immediately have someone call 911 and, at the same time, jump into action: An adult or older child should receive five blows to their back to try to remove the foreign body, followed by five abdominal thrusts if back blows didn’t work. Repeat this cycle twice if needed.

If choking continues, now’s the time to use the Dechoker. Insert the device’s tongue depressor into the person’s mouth and over the tongue, get a tight seal over their nose and mouth, and tilt their chin up to open the airway. Then quickly pull back on the Dechoker. If the person stops breathing, give breaths and do a finger sweep to look for a foreign object. If none is found, starting CPR is the only option. Mayo Clinic offers additional key details on how to help someone who is choking, and ACLS Medical Training gives specifics for infants.

Using the Dechoker correctly is important. Familiarize yourself with the device and how it works, and watch the company’s training video. It’s especially critical that you understand how to keep the mask sealed over the airway.

Pros

Cadaver research, a simulation study, and two retrospective studies (research using data from past events) have looked at how anti-choking devices are used. In a small retrospective study that examined use of the Dechoker in a nursing home, researchers concluded this tool might be helpful for people who are frail or movement-restricted.

Cons

Study findings also pointed to several drawbacks of using the Dechoker and other airway clearing devices. For example, some people with SMA use respiratory equipment, which might need to be removed to access the airway during a choking emergency. Tooth and lip damage also have been reported as adverse events.

After evaluating studies of the effectiveness of suction-based airway clearance devices, the Resuscitation Council of the United Kingdom decided not to recommend their use. This group was concerned that besides the lack of evidence for the devices’ effectiveness, their use might delay proper care for someone who’s choking. The council also wondered whether the suction force could cause stomach contents to enter the lungs, leading to pneumonia or other trauma. The American Red Cross likewise doesn’t include devices in their training because of the lack of evidence.

Officials at St. Luke’s Children’s Hospital in Boise, Idaho, have expressed concern that anti-choking devices could lead to a false sense of security — parents who buy them might not learn established lifesaving techniques for choking, including the Heimlich maneuver and CPR.

LifeVac

LifeVac, another version of a portable anti-choking device, retails for about $70 for a home kit. This suction tool uses a one-way valve to prevent air from pushing a foreign object further down.

The LifeVac portable anti-choking device uses suction to prevent air from pushing a foreign object further down a person’s airway. (LifeVac)

How Is It Used?

LifeVac includes a plunger that forces air out when pushed down and applies suction when pulled all the way back. To use the device, first properly place the attached face mask, forming a seal over the nose and mouth of the choking person. Next, pull up on the plunger to remove the blockage — the idea is to suction the foreign object upward to clear the airway. LifeVac should not be used on anyone weighing less than 22 pounds.

Pros

As with the Dechoker, there is limited research regarding LifeVac. A small global study found that LifeVac resolved symptoms in 123 of 124 people who were choking. A 2022 study of self-reported experiences found that for 38 of 39 adults with known swallowing problems who had a choking event, the device removed the obstruction. The findings were published in the journal Frontiers in Medicine.

Cons

Many of the above concerns about the Dechoker apply to LifeVac too. The global study included a report of a LifeVac mask disconnecting while being used.

The Bottom Line on Anti-Choking Devices

Overall, current guidelines of medical organizations recommend back blows, abdominal thrusts, and CPR as the go-to interventions for someone who’s choking. Knowing CPR and basic choking first aid to help your loved one can be lifesaving.

The research is still too sparse to recommend the use of airway clearance devices such as the Dechoker and LifeVac. It’s also unclear if one or the other would work better on adults or children.

Despite these drawbacks, there may be a benefit to having an anti-choking device on hand. There might be some peace of mind in knowing that you have a backup in an emergency. Additionally, even though more research is needed, some of the early findings are promising. However, following established guidelines to address choking is always the best option.

If you do plan to use an anti-choking device, it’s critical that you follow its instructions exactly and get training. Improper use will make the device ineffective and could even dislodge the foreign body and push it farther into the airway, making choking worse and endangering the person’s life. Speak to your doctor before purchasing one of these aids, and ask about the specific benefits and drawbacks related to your symptoms of SMA.

Can You Use an Anti-Choking Device on Yourself?

In theory, you can use an airway clearance device on yourself. However, choking is a traumatic experience, causing severe panic, and time is limited before you might stop breathing and become unconscious. It may not be safe to rely on using a device to save your own life when you’re choking. Talk to your health care provider about ways to help avoid these emergencies from arising in the first place.

Talk With Others Who Understand

On MySMAteam — the social network for people with SMA and their loved ones. — members come together to ask questions, give advice, and share their stories with others who understand life with SMA.

Are you or a loved one at risk of choking because of SMA? Have you purchased an airway clearance device or considered buying one? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Class I and Class II Device Exemptions — U.S. Food and Drug Administration
  2. Choking: First Aid — Mayo Clinic
  3. Doctor’s Corner Q+A — Dechoker
  4. BLS Choking Infant Algorithm — ACLS Medical Training
  5. The Dechoker Instructions — How It Works — Dechoker
  6. Anti-Choking Suction Devices Use. A Pilot Simulated Study With Parents and Kindergarten Teachers — Resuscitation
  7. The Efficacy and Usability of Suction-Based Airway Clearance Devices for Foreign Body Airway Obstruction: A Manikin Randomised Crossover Trial — Resuscitation Plus
  8. Phase One of a Global Evaluation of Suction-Based Airway Clearance Devices in Foreign Body Airway Obstructions: A Retrospective Descriptive Analysis — International Journal of Environmental Research and Public Health
  9. Evaluation of DeChoker, an Airway Clearance Device (ACD) Used in Adult Choking Emergencies Within the Adult Care Home Sector: A Mixed Methods Case Study — Frontiers in Public Health
  10. RCUK’s Position on the Use of Suction-Based Airway Clearance Devices on Choking Victims — Resuscitation Council UK
  11. Legislation Requiring Anti-Choking Devices in Schools Draws Doctors’ Concern — New Jersey Monitor
  12. Children's Hospital Staff Warns Parents About Anti-Choking Devices — Argus Observer
  13. Use of a Novel Portable Non-Powered Suction Device in Patients With Oropharyngeal Dysphagia During a Choking Emergency — Frontiers in Medicine
  14. Frequently Asked Questions — LifeVac
  15. LifeVac Home Kit — LifeVac
  16. A Protocol for the Prospective Evaluation of Novel Suction-Based Airway Clearance Devices in the Treatment of Foreign Body Airway Obstructions — Cureus
    Posted on May 25, 2023
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    Luc Jasmin, M.D., Ph.D., FRCS (C), FACS is a board-certified neurosurgery specialist. Learn more about him here.
    Remi A. Kessler, M.D. is affiliated with the Medical University of South Carolina and Cleveland Clinic. Learn more about her here.

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