When is the Life Vac (suction device) recommended for use in a clinical setting?

Life Vac Suction Device: Not Recommended for Clinical Use

Suction-based airway clearance devices like the Life Vac are not recommended for routine use in clinical settings due to insufficient evidence of efficacy and safety concerns. 1

Current Guidelines on Foreign Body Airway Obstruction Management

• The 2020 and 2022 International Consensus on Cardiopulmonary Resuscitation specifically recommends against the routine use of suction-based airway clearance devices for foreign body airway obstruction (weak recommendation, very low-certainty evidence) 1

• For conscious patients with foreign body airway obstruction, the recommended approach is to:

  • Encourage coughing as the initial response 1
  • Use back slaps if coughing is ineffective 1
  • Progress to abdominal thrusts if back slaps are ineffective 1

• For unconscious patients with foreign body airway obstruction:

  • Chest thrusts are recommended 1
  • Manual extraction of visible items in the mouth may be considered 1
  • Healthcare providers with appropriate skills may use Magill forceps to remove foreign bodies 1

Evidence Regarding Life Vac and Similar Devices

• While there is a case series reporting successful use of the Life Vac device in 38 out of 39 patients with oropharyngeal dysphagia during choking emergencies 2, this evidence is considered insufficient to override guideline recommendations

• A 2023 cadaver study found that the Life Vac was only successful in removing barium-moistened saltine crackers but failed to remove other types of foreign bodies, and may cause significant pressure and injury to the oral cavity 3

• Another study of a prototype portable non-powered suction device showed laboratory-measured peak airway pressures of 434.23 ± 12.35 cm H2O 4, which far exceeds the recommended suction pressures of 80-100 mmHg for clinical procedures 5

Potential Risks and Concerns

• Excessive vacuum pressure increases the likelihood of mucosal damage 5

• Suction devices may cause trauma to the oropharynx, including potential injury to the tongue 3

• Using unproven devices may delay implementation of established, evidence-based interventions for foreign body airway obstruction 1

• Reliance on such devices may create a false sense of security in emergency situations 1

Clinical Implications

• Healthcare facilities should maintain standard airway management equipment including:

  • Portable and installed suction devices with adequate vacuum and flow for pharyngeal suction 1
  • Large-bore, nonkinking suction tubing and semirigid pharyngeal tips 1
  • Sterile suction catheters of various sizes 1

• For tracheostomy patients, emergency kits should include appropriate suction equipment, but specialized devices like Life Vac are not part of standard recommendations 1

• Healthcare providers should focus on maintaining proficiency in established airway management techniques rather than adopting unproven devices 1

Conclusion for Clinical Practice

• Follow established guidelines for managing foreign body airway obstruction 1
• Continue to use conventional suction equipment that allows for pressure regulation 1
• Await further high-quality evidence before considering implementation of specialized suction devices like Life Vac 1
• Focus on prevention and early intervention for patients at high risk of choking 1