Choking Health Article

Choking

Blockage of the throat or windpipe by an object.

Choking is a major cause of death for children under three, and is a hazard for older children as well. Young children explore the world with their mouths, and they will naturally put in their mouths anything that fits. If a small object slips back into the throat and blocks the windpipe, the child may become unable to breathe, and unless the child is helped to eject the object quickly, the child may asphyxiate and die. Food is also a choking hazard, especially for children under three who do not know how to chew food thoroughly. Parents should encourage children to chew, and warn them not to eat while running or playing, or to eat lying down.

Prevention

The common household is full of objects such as coins, tacks, paper clips, buttons, pins, beads, pen caps, bottle tops and nails that pose a choking danger to children. It is of course not possible to rid the house of small items, but parents can take care to keep them out of reach. When childproofing the house, parents should view each room from the child's point of view, that is, from down on the floor. By crawling around a rug and looking up at the undersides of furniture, parents can find inconspicuous items that might attract a child's attention but escape the adult's-eye view from above. Crawling babies will go behind and under furniture and worm their way into corners, so even very tight spaces should be checked. Parents should be careful with what they throw in the garbage since toddlers may retrieve small objects that have been thrown away. Egg shells and pull-tabs from beverage cans are both choking hazards commonly found in the garbage.

Toys and parts of toys also pose a danger to young children. Federal law specifies that toys designed for children under three pass a small parts test. Toys or parts for children this age must be able to pass through a tube approximating a child's throat diameter (just over 1 in [3 cm]). However, some children have choked to death on objects that passed the small parts test, and the Consumer Product Safety Commission proposed in 1988 that the test be revised, changing the diameter of the tube to over 1.5 in (4 cm). However, the new diameter has not been adopted and as the test does not apply to toys designed for children over three, parents of several children must be sure that small toys for an older child do not fall into a younger sibling's hands. One solution is to keep toys that are safe for toddlers as well as older children in a general toy box, and keep toys that have small parts in a special area, so that these can be taken down only with adult assistance.

A recent study of the characteristics of objects known to have caused choking deaths in children found that round objects are most dangerous. A small ball or marble can completely seal the windpipe. Round or cylindrical foods are also a particular choking hazard. Round pieces of hot dog, nuts, whole grapes, seeds, and hard candies should not be given to young children, and older children should be watched with care when eating these foods. Another significant choking risk to children of all ages is balloons. Children can inhale a balloon while trying to inflate it, or choke on a piece of popped balloon. If children are given balloons, they should be supervised closely.

Treatment

A child who is choking cannot talk or cough. If the airway is completely blocked, the child will turn red, then blue. The parent or caretaker must act immediately to save the child. The accompanying sidebar provides guidelines for what to do in an emergency. All parents and caregivers should become familiar with these procedures, so that they will be ready should an emergency arise. Parents can prepare themselves for choking incidents by taking child safety and first aid classes offered by many community resource centers and health agencies.