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Choking rescue with a LifeVac device

Key points

  • The LifeVac is a backup device to use after back blows and abdominal thrusts have failed—not a first-line tool.
  • Stay calm and use simple, reassuring words. Panic in the caregiver increases panic in the person with dementia.
  • Practice assembling and using the LifeVac before an emergency so you are not fumbling in a crisis.
  • Always call 911 for a choking emergency, even if you successfully remove the object. Complications can arise later.
  • Personalize your approach based on the person's dementia stage, disease type, and physical abilities.
  • Discuss choking risks and emergency plans with your loved one's entire care team, including doctors, nurses, and aides.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. If the person is coughing forcefully, encourage them to keep coughing. If they are silent, cannot cough or speak, or are turning blue, call 911 and begin rescue efforts immediately.

  2. If conscious and able to stand, give up to 5 sharp back blows between the shoulder blades. Support their chest with one hand, lean them forward, and check after each blow.

  3. If back blows fail, perform abdominal thrusts (Heimlich). Stand behind, place a fist just above the navel, and thrust inward and upward. Use less force if frail or osteoporotic; use chest thrusts if pregnant or too large to reach around.

  4. If unconscious, lower them to the floor on their back, tilt the head back and lift the chin. Sweep the object out with your finger only if you can clearly see it—never do blind finger sweeps.

  5. To use LifeVac: attach the correct mask (pediatric for child/small adult, adult otherwise) to the plunger. Lay the person on their back and place the mask firmly over nose and mouth, ensuring an airtight seal.

  6. Press the plunger down gently until you feel resistance, then pull it back sharply. A suction sound indicates the obstruction is being pulled into the mask.

  7. Remove the mask and check the mouth. If you see the object, lift it out. Repeat LifeVac up to 5 times; if blockage remains, continue standard CPR until emergency services arrive.

  8. Once the airway is clear, turn an unconscious person onto their side into recovery position. If conscious, sit them up slowly and monitor. Offer small sips of water only when fully alert and swallowing safely.

What not to do

  • Do not reach for the LifeVac first—always attempt back blows and abdominal thrusts first.

  • Do not force the LifeVac mask onto a person who is fighting you; pause to calm them first.

  • Do not perform blind finger sweeps—you may push the obstruction deeper.

  • Do not offer food or drink after a choking episode, even if they seem fine.

  • Do not leave the person alone after the episode; watch for coughing, fever, or breathing difficulty.

Practical tools

  • LifeVac Device

    A portable, battery-free suction device with adult and pediatric masks. Keep one where the person usually eats. Practice assembly once before an emergency.

  • Penlight or Small Flashlight

    A bright, focused light to clearly see an obstruction in the mouth before attempting a finger sweep, especially in dim lighting.

Discuss with your clinician

Ask your loved one's doctor or speech-language pathologist: 'What is the safest food texture and liquid thickness for my loved one to reduce choking risk?' Do not change their diet without professional guidance.

Discuss whether a 'do not resuscitate' (DNR) or 'do not intubate' (DNI) order applies to choking rescue with a device like LifeVac. Some advance directives may exclude any airway intervention. Clarify this with the doctor and document it clearly.

If your loved one has had multiple choking episodes, ask about a referral to a swallowing specialist (speech-language pathologist) for a formal swallowing evaluation. They may recommend exercises or positioning strategies.

Ask the doctor if any medications your loved one takes could cause dry mouth or drowsiness, both of which increase choking risk. Do not stop or change any medication without medical advice.

If your loved one is on hospice, ask the hospice nurse: 'What is the protocol for choking? Should I use the LifeVac, or is comfort care the priority?' This conversation is essential to avoid conflicting actions during an emergency.

Ask your doctor: 'Is the LifeVac device appropriate for my loved one given their specific health conditions and dementia stage?'

Ask your doctor: 'What is the correct amount of force to use for back blows and abdominal thrusts on a frail person with dementia to minimize injury risk?'

Related guides

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