It can be terrifying when someone starts choking while eating. For many children and adults living with spinal muscular atrophy (SMA), this is a real risk. SMA can weaken the muscles involved in chewing and swallowing, making choking more likely.

If you or a loved one has SMA, being ready to take quick, potentially lifesaving action is essential. You may wonder whether an antichoking device, such as the Dechoker or LifeVac, could help in an emergency.

Choking is a serious hazard for people with SMA. The condition can affect the strength and coordination of muscles used for eating and breathing. If you or someone close to you lives with SMA, you might be thinking about keeping an airway clearance device on hand — just in case.

This article breaks down the differences between the Dechoker and LifeVac — how each device works, what we know about their effectiveness, and what to consider before choosing one.

Notably, suction-based airway clearance devices like these are widely available to consumers, but it’s important to know they are not approved or cleared by the U.S. Food and Drug Administration (FDA). They are registered with the FDA as class 2 medical devices, which does not involve FDA review for safety or effectiveness.

Dechoker

The Dechoker is a portable, handheld suction device with a one-way valve. It’s designed to prevent air from being pushed back into the airway, which could make choking worse. The device can be used by anyone 12 months of age or older, and it comes in different sizes for toddlers, children, and adults.

How Is It Used?

If someone is choking, have another person call 911 right away. At the same time, begin emergency care. For an older child or adult, the American Red Cross recommends these steps:

1. Use the heel of your hand to give five firm back blows between the shoulder blades.
2. If the object doesn’t come out, perform five abdominal thrusts (also known as the Heimlich maneuver).
3. Repeat the cycle of back blows and abdominal thrusts up to two more times if needed.

If the person is still choking, this is when you may consider using the Dechoker, following these steps:

1. Insert the device’s tongue depressor into the person’s mouth, over the tongue.
2. Make sure the mask forms a tight seal over the person’s nose and mouth.
3. Tilt their chin up to help open the airway.
4. Pull back quickly on the plunger.

If the person stops breathing, give breaths and do a finger sweep to look for a foreign object. If none is found, start CPR. Mayo Clinic and Advanced Cardiovascular Life Support (ACLS) Medical Training offer more guidance on what to do when someone is choking — including infant-specific instructions.

Using the Dechoker correctly is important. Watch the company’s training video and make sure you know how to create a strong seal with the mask before an emergency happens.

Pros of the Dechoker

Several studies have looked into how suction-based antichoking devices are used. These include a cadaver simulation and two retrospective studies (which analyze past events to draw conclusions).

One small study in a nursing home setting suggested the Dechoker might be helpful for people who are frail or have limited mobility.

Another small study found that the Dechoker was sometimes effective when traditional methods, like the Heimlich maneuver, didn’t work.

Cons of the Dechoker

Study findings also have 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 have also been reported as adverse events.

The Resuscitation Council of the United Kingdom does not recommend these devices due to limited evidence and the potential for delays in proven care. The Council also raised concerns that the suction could pull stomach contents into the lungs, leading to pneumonia or other complications.

The American Red Cross does not include these devices in their official training because of the lack of strong evidence.

Health experts at St. Luke’s Children’s Hospital have expressed another concern: Antichoking devices might give caregivers a false sense of security. Some people might purchase these tools instead of learning essential skills like abdominal thrusts and CPR — techniques that remain the gold standard for managing choking.

LifeVac

LifeVac — another type of portable antichoking device — sells for about $70 as part of a home kit. Like the Dechoker, this suction tool uses a one-way valve to prevent air from pushing a blockage deeper into the airway.

How Is It Used?

LifeVac has a plunger that pushes air out when pressed down and creates suction when pulled back. The goal is to lift the object upward and clear the person’s airway. To use LifeVac:

1. Place the mask on the person’s face.
2. Form a tight seal over their nose and mouth.
3. Pull up on the plunger to try to remove the object.

LifeVac is not recommended for people who weigh less than 22 pounds.

Pros of the LifeVac

As with the Dechoker, there is limited research on the LifeVac. One small global study found that LifeVac helped clear the airway in 123 of 124 people during choking incidents.

A 2022 study published in the journal Frontiers in Medicine looked at the self-reported experiences of adults with swallowing problems. The study found that LifeVac removed the obstruction in 38 of 39 adults during a choking event.

Another small study looked at Dechoker and LifeVac devices as used by medical students during a simulated choking incident with a manikin (a practice model used in CPR training). The study measured how often each method cleared the airway within four minutes and within one minute.

Results showed that removal of a foreign object within four minutes was successful in:

• 99 percent of uses for LifeVac
• 74 percent of uses for Dechoker
• 71 percent of uses for abdominal thrusts

Removal of a foreign object within one minute was successful:

• 82 percent of the time with LifeVac
• 44 percent of the time for Dechoker
• 67 percent of the time for abdominal thrusts

Cons of the LifeVac

Many of the above concerns about the Dechoker apply to LifeVac. For example, the global study included a report of the LifeVac mask disconnecting during use.

Another small study looked at medical students who used LifeVac and Dechoker devices during simulated choking. Researchers found that some students skipped steps in the standard choking protocol — such as giving back blows — when using antichoking devices like LifeVac or the Dechoker.

Can You Use an Antichoking Device on Yourself?

In theory, you can use an airway clearance device on yourself. However, choking is a frightening and physically intense experience that often causes panic. Time is also limited — if your airway stays blocked, you may stop breathing and lose consciousness within a few minutes if the airway remains completely blocked.

Because of this, it may not be safe to rely on a device to save your own life during a choking emergency. Ask your doctor for tips on how to reduce choking risks and what to do if you're alone when it happens.

Antichoking Devices: Can They Help?

Currently, medical organizations recommend back blows, abdominal thrusts, and CPR as the primary ways to help someone who is choking. Knowing these skills — or making sure someone nearby does — can be lifesaving.

At this time, there isn’t enough research to fully recommend suction-based airway devices like the Dechoker or LifeVac. It’s also unclear whether one works better than the other for adults or children.

That said, some people choose to keep an antichoking device on hand for peace of mind — as a backup tool in case other methods don’t work. Although more research is needed, some early findings are promising.

If you decide to use an antichoking device, it’s important to:

• Get trained on how to use it safely.
• Follow the manufacturer’s instructions exactly.
• Understand the risks, including pushing the object deeper into the airway if used incorrectly.

Always talk to your healthcare provider before purchasing an airway clearance device. They can help you understand the pros and cons — especially as they relate to spinal muscular atrophy.

Talk With Others Who Understand

On mySMAteam, the social network for people with SMA and their loved ones, more than 2,700 members come together to ask questions, give advice, and share their stories with others who understand life with SMA.

Have you or someone close to you ever had a choking scare because of SMA? Have you used or thought about getting an antichoking device like the Dechoker or LifeVac? Share your experience in the comments below, or start a conversation by posting on your Activities page.