Choking Health Article

Diagnosis

Choking is diagnosed by observation of the choking victim. Children able to actively cough should be watched to make sure they expel the object on their own and that their airways do not become blocked. Indications that a choking victim's airway is blocked include the following:

• inability to cough, cry, or speak
• blue or purple face color from lack of oxygen
• grabbing at throat
• weak cough and labored breathing that produces a high-pitched noise
• all of the above, followed by loss of consciousness

When the actual choking incident is not observed, choking can be diagnosed by observing the above symptoms. For children, infants, and adolescents who are unconscious, choking and foreign body obstruction can be diagnosed by attempting to give rescue breaths. If a breath administered to the victim does not inflate the chest, rescuers should assume that the airway is blocked and take steps to clear the airway.

Treatment

An emergency choking incident is treated using the Heimlich maneuver, usually administered by parents, caregivers and teachers, or bystanders. Children who have a choking incident that requires the Heimlich maneuver should be examined by a physician for potential injuries to their airway and aftereffects of oxygen deprivation.

The Heimlich maneuver is used when a child is choking on a foreign object to the extent that he/she cannot breathe. Oxygen deprivation from a foreign body airway obstruction can result in permanent brain damage or death in four minutes or less. Using the Heimlich maneuver can save a choking victim's life. The Heimlich maneuver is not performed on infants under one year of age; rather, a series of back blows and chest thrusts are used to attempt to dislodge the foreign object.

If the foreign body cannot be expelled from the child's airway using the Heimlich maneuver, cardiac and/or respiratory arrest may occur, and the child may stop breathing. If this happens, cardiopulmonary resuscitation (CPR) is performed to restore and maintain breathing and circulation and to provide oxygen and blood flow to the heart, brain, and other vital organs. CPR can be performed by trained laypeople or healthcare professionals on infants, children, adolescents, and adults. CPR should be performed if an infant, child, or adolescent is unconscious and not breathing.

Prognosis

Incorrectly applied, the Heimlich maneuver can break bones or damage internal organs. Following the Heimlich maneuver, dysphagia (swallowing difficulty) and obstructive pulmonary edema (fluid accumulation in the lungs) may occur and require medical treatment.

In many cases the foreign material is dislodged from the throat, and the choking victim suffers no permanent effects of the episode. If the foreign material is not removed, the choking victim may suffer permanent brain damage from lack of oxygen or may die.

Prevention

Choking is easily preventable by taking the following steps:

• supervising infants and children while they eat and play
• childproofing play areas by removing small objects
• cutting foods into very small pieces
• avoiding serving foods listed above as choking hazards to children under age four
• monitoring older children to make sure they do not give younger children hazardous foods or objects
• following age and safety guidelines on toys
• learning CPR and the Heimlich maneuver
• not letting children and infants play with coins