The U.S. Food and Drug Administration recently authorized LifeVac, a suction-powered device designed to dislodge airway obstructions, for use when standard choking rescue protocols have failed. This de novo clearance establishes a regulatory framework for such devices as second-line treatments. Previously, the FDA had warned against using these devices before established methods, citing potential delays in critical action, and had issued a warning letter to LifeVac for marketing its device without proper authorization, which was later closed.
Despite the FDA's authorization of LifeVac, leading medical organizations, including the American Red Cross and American Heart Association, continue to endorse back blows and abdominal thrusts (the Heimlich maneuver) as the primary and most effective methods for assisting a choking person. These traditional techniques, which have a high success rate, can be performed immediately without the need for additional equipment, saving valuable time in an emergency. The American Red Cross's scientific advisors are considering suction-powered devices but still recommend back blows and abdominal thrusts while the person is conscious.
Anti-choking devices, typically costing between $30 and $100, are gaining traction in various settings. Texas enacted a law requiring schools to stock at least one device, and New York City passed legislation to mandate them in schools, though its implementation is pending medical guidance on use in children. The company LifeVac has reported nearly 3,000 lives saved with its device and suggests schools stock multiple units, for example, in offices, cafeterias, and with athletic staff. However, concerns have been raised about the potential for companies with profit motives to influence policy decisions regarding these devices, as well as the cost to taxpayers, with a City Council estimate for NYC schools at $5.4 million for over 2,700 schools.
