Choking – Causes, Signs, Rescue Procedures, And Prevention Tips

Do you know that choking has resulted in the death of several small children below the age of three? It has become one of the top problems leading to infant death. Foods, coins, small toys, or other objects can result in choking deaths. Fatalities often occur due to the object getting stuck in the throat. It leads to obstruction of the airways. When you choke, the brain cells can die within ten minutes. To avoid such fatalities, you need to maintain caution. If you have small children or the elderly at your home, you need to read this. You can become aware of the procedures that will help yourself or another person suffering from the problem. Equipped with the knowledge of these life-saving tips, you can rescue the person from serious complications.

About Choking

Choking seems common in the elderly and infants. According to studies, suffocation has emerged as one of the major causes of suffering from injuries leading to death. Young children face the problem higher due to having smaller airways. It can lower their ability to bite and chew the food provided to them. Young children tend to have a curious nature. As they explore their surroundings, they can place the objects within their reach into their mouth.

Why Does Choking Happen?

In human beings, the respiratory tract starts at the nose. It has a nasal passage and mouth that joins at the throat. This forms an air pipe, known as the trachea. The ai pipe remains open due to the presence of C-shaped cartilage pieces. A foreign body blocking a person’s airway partially or completely can result in compromising the air passing into and out the lungs. The seriousness of the compromise depends on the severity of the airway blockage. In extreme cases, no air can pass through the lungs.

It is a medical emergency requiring immediate medical assistance. Without oxygen, the brain can become deprived of oxygen and the damage starts. In less severe cases, the air entry has no reduction. But, you can experience pain or discomfort.

Causes Of Choking

When any object, a piece of food, or liquid becomes lodged in the throat, it can make a person choke. Adults and children can suffer from the problem. But, it can become deadly in children and old people.

Causes Of Choking In Adults

Adults can experience gagging when they eat or drink too fast. Not chewing the food properly before swallowing can also cause gagging. Another possibility of gaging while eating includes swallowing small bones or other food items. Laughing while eating or drinking can also result in gagging. Breathing fumes can also make them choke. Inhaling small objects can also result in a problem.

Choking In Children Causes

In children, the condition occurs when they place any foreign objects in their mouths. The common objects children can choke on include:

• Toys
• Pencil erasers
• Candies
• Coins
• Grapes or cherry tomatoes
• Popcorn
• Hot dogs
• Balloons
• Peanuts
• Carrots
• Large pieces of fruits or vegetables

Symptoms Of Choking

Choking can occur while eating food or accidental swallowing of food/objects. You can identify the problem with certain signs. The symptoms linked to the condition include:

• Rapid coughing
• Difficulty in breathing
• Inability to speak or make any noise
• Lack of oxygen causes a bluish tint of skin, nails, or lips

Most people suffering from gagging, tend to have their hands on their throats. It is to let others know regarding their condition. Gagging can occur in front of others or when no one remains around. It is better to learn the first aid techniques that will help get the breath back and avoid complications. Once you administer first aid, go to a hospital immediately to get the necessary treatment.

Steps To Take When You Experience Choking

If you experience choking, then try to cough forcefully to prevent any issue. The force of your coughing can expel the object or food stuck in your throat. Thrusting one of the thumbs between the ribcage and belly button and pushing hard in a quick motion can dislodge the object. It is another option to help yourself from gaging. The method exerts pressure on the diaphragm causing compression of the lungs. This forces the remaining air to push through the trachea. It can clear the airway. While doing this motion, you can lean over a sturdy chair. Call for medical help if you cannot dislodge the object and feel breathless.

Steps To Take When Someone Else Experiences Choking

On the other hand, when you see someone choking, you can try the steps suggested below to help the person breathe properly.

• Ask the person to cough forcefully until the object dislodges.
• If the person choking cannot talk, laugh, or cry, you can try the “five-and-five” approach. First, you need to give five back blows by standing behind the person experiencing choking. IF a child is experiencing the problem, you need to kneel behind. To support, you need to place an arm across the chest of the person. Keep the upper body parallel with the ground by bending the person over the waist. Deliver five back blows again between the shoulder blades of the person using the hand’s heel. You must also perform five abdominal thrusts known as the Heimlich maneuver. Do these five blows and five thrusts until the block dislodges.
• Learn the technique well before trying it on people. You can try both approaches as they can offer results.

Steps To Perform Heimlich Maneuver On Others

You need to follow the steps suggested below to perform abdominal thrusts, also known as the Heimlich maneuver on others experiencing choking.

• Stand behind the affected person by placing one foot slightly in front of the other. It gives you the balance. Now, wrap your arms around the waist of the person. Tip the person slightly forward. In the case of a child, kneel behind the child.
• Make a fist and place it slightly above the affected person’s navel.
• Grasp the fist with the other hand and press hard into the abdomen. You need to give a quick, upward thrust that may resemble trying to lift a person.
• You can perform six to ten abdominal thrusts to dislodge the blockage.
• Call for help before performing the abdominal thrusts. If someone else is present, make them while you perform the first aid. If the person loses consciousness, you need to perform CPR with chest compression for making them breathe.

Steps To Perform Abdominal Thrusts

If you want to perform abdominal thrusts on yourself, you need to follow the steps suggested below:

• You may think you cannot deliver back blows by yourself while choking, but you can try to perform the Heimlich maneuver to dislodge the obstruction. Call emergency number immediately before trying this to get medical assistance as early as possible.
• First, place the fist slightly above the navel.
• Grasp your fist with the other hand. Bend over a chair or a countertop (any hard surface).
• Shove the fist inward and upward until the object dislodges.

Steps To Clear The Airway Of A Obese/Overweight Person

If an obese or overweight person seems to choke, you need to perform the following techniques to clear the airways:

• Place the hands at the base of the breastbone, the place just above the lowest ribs joins.
• You need to proceed with the Heimlich maneuver. Press hard with a thrust into the chest.
• Repeat the quick thrust until the block clears.
• If the person faints during the process, you can follow the steps suggested below.

Techniques To Clear The Airway Of An Unconscious Person

When a person experiencing choking can fall unconscious, you need to take steps to revive them. You can follow the steps suggested:

• Lower the unconscious person on their back. Place them on the floor with arms on the side.
• If you can see the blockage high in the throat or at the back of the throat, you can use the finger to sweep the object causing the blockage. Never use a finger sweep when you cannot see the object obstructing the airway. Also, maintain careful not to push the object or food further down the airway. It can happen when dealing with small children.
• If the object remains lodged and the person fails to respond after you take the steps mentioned, begin CPR. The compression in CPR may dislodge the food or object. Check the mouth periodically.

Technique To Clear Airway Of Choking Infant Below One Year

If an infant younger than one year has swallowed something accidentally, they face the risk of gagging. Immediate first aid is necessary to save the baby. You can follow the steps suggested to prevent any fatal complications:

• After sitting down, place the infant face-down on your forearm. Rest the forearm on the thigh. Use your hand to support the baby’s head and neck while the head remains lower than the trunk.
• You need to thumb the infant’s back gently yet firmly five times using your hand’s heel. The back blow and gravity can release the object obstructing the airway. Avoid hitting the infant’s back of the head by pointing the fingers upward.
• If the infant still does not breathe, turn the baby face-up on the forearm. Rest your forearm on the thigh with the head lower than the trunk. Give chest compressions five times by using two fingers placed at the infant’s center of the breastbone. You need to press down for one and a half inches and allow the chest to rise between the compression.
• Repeat the chest thrusts and back blows if the baby does not resume breathing. Call for medical assistance.
• Start CPR if any techniques open the airway but the baby has not resumed breathing.

For babies older than one year, only give abdominal thrusts. Avoid using too much force as it may impact internal organs and ribs.

Diagnostic Tests To Find Out The Cause Of Choking

After performing the first aid, the affected person needs emergency medical care. So, you need to get the assistance of a doctor at the hospital. At the hospital, the doctor can perform several diagnostic tests to detect the exact reason that caused the gaging. These tests are also essential to detect if objects are obstructing the airways and need removal. The tests performed includes:

X-Rays For Detecting Reason For Choking

X-rays help visualize the internal organs. Hence, it may aid doctors in looking for any objects obstructing the airways. The x-rays help find the place and object causing the partial blockage. In people suffering from gagging due to dysphagia, x-rays used with barium solution can help detect the blockage in the esophagus. For this type of x-ray, you need to drink the barium solution that coats the esophagus. The x-ray taken after that will help see changes in the esophagus shape.

Using this, the doctor can assess muscular activity. If barium solution fails to work, the doctor provides solid food or a barium pill. Then, the doctor watches the muscles in the throat as you swallow. It will look for blockages that barium solution fails to identify.

Bronchoscopy

If any foreign substance has lodged in the lungs or airways, bronchoscopy can detect it. The procedure uses a small camera fitted at the end of a thin and flexible tube. The doctor inserts the bronchoscope through the nose or mouth. It is sent down the throat to the lungs. The camera sends images of the airways and lungs that help the doctor detect the obstruction.

Endoscopy

If your doctor suspects dysphagia, you need to undergo an endoscopy. It is the test used to detect the state of your esophagus. The doctor lowers an endoscope, a thin, flexible tube with a light at its end, through the throat. It helps the healthcare provider to see the esophagus. The medical professional may also take biopsies of the esophagus to check for any presence of inflammation, tumor, narrowing of the esophagus, or eosinophilic esophagitis.

Choking Treatment

The immediate treatment for choking or asphyxia includes CPR and abdominal thrusts. Later, the doctor can suggest the following treatment options to make it easier for the patient to breathe:

Intubation

Intubation refers to the process of inserting a scope or tube into the nose or mouth. It is moved to the airway to see and remove the obstruction. It will help move the air in and out of the lungs. The process is performed to support breathing. The doctors use a special instrument known as Magill Forceps to remove the obstruction.

Cricothyrotomy

In serious cases of choking, the affected person needs to undergo cricothyrotomy. It is performed as an emergency procedure when other methods prove ineffective. During the procedure, the surgeon makes a hole in the neck. A tube is inserted through the hole for ease of breathing.

Life Support

In some cases, patients may have to put on life support for easy breathing.

First Aid Recommendations For Choking

A person choking at home requires treatment depending on their age. If a child or an elderly person suffers from gagging, they need emergency medical assistance. A person losing consciousness in between getting first aid treatment also needs medical assistance. It is vital to perform CPR until the emergency help arrives. Here are some tips you need to follow while administering CPR:

• You can perform abdominal thrusts. Make sure it remains firm but gentle.
• If the child loses consciousness or does not respond, quickly administer CPR.
• While these first aid tips may rescue the child, call for medical help before performing the at-home first aids. It is helpful to restrict the grave situation from escalating into something fatal.
• After the medical team arrives, they can manage the situation well. The medical team can eliminate any remnants of the object still obstructing the throat.

Tips To Prevent Choking

Choking is a common problem that anyone can suffer at any point in time. But, it is common among children below four years of age. As choking can turn out to be life-threatening, it is best to steer clear of it as much as you can. Here are some prevention tips to help you.

Precautions To Take To Avoid Choking In Children While Eating

Parents or adults taking care of children need to follow the tips to avoid choking when they eat food:

Make Them Sit

You need to make your child sit on a high chair, table, or even surface-like floor when they eat. Gagging of food occurs when they eat while running around, lying down, or playing. To avoid the temptation of running around, you can sit with your child while they eat. Talking, singing, or entertaining them when they eat will make them focus on the food.

Encourage Chewing

You need to encourage your child to chew well before they swallow the food. Give them guidance on how to chew and swallow. Ask them to take time to chew during meals. It will lower the risk of gagging.

Give Them Small Food Pieces

Until your child becomes old enough to chew properly, you need to give them small pieces. Make sure you cut to give them food pieces smaller than a pea. It will pass through their food pipe with ease. Anything bigger can make it difficult for your little child to eat safely. Small children have small airways. Also, they are learning the basics of chewing and swallowing properly.

Make Food Easier To Swallow

Make sure your child can swallow the food you give with ease. You can cook, mash, or grate the food items. It is necessary when you give them hard fruits and vegetables such as apples and carrots.

Never Give Certain Foods

Until your child can swallow food with ease, avoid hard foods and nuts. You must keep away the following food items from your child:

• Grapes
• Corn chips
• Lollies
• Marshmallows

Also, avoid giving a baby formula bottle in their bed. Babies falling asleep with the bottle tend to draw liquid that can enter the lungs. It increases their chances of choking on it.

Prevent Choking In Children At Home

Apart from choking risk in children while eating food, they can also face the risk with certain things at home. Here are some of the tips you can follow to protect the child from gaging.

Keep Small Objects Away

You need to keep all the small objects away from your child. Small children have a curious nature. They tend to reach for small things within their reach and put them in their mouths. Such small objects increase the risk of gagging. Hence, check the floor for any objects that can cause such issues. You need to get down to the height of your child to look around properly and eliminate the risk.

Follow Age Recommendations On Toys

The toys come with age recommendations. Follow it to avoid complications. While choosing a toy, ensure it has a solid and sturdy structure. Never buy your child a toy with small or breakable parts. Avoid toys with brittle surfaces. Before giving it to play, check the toys for any exposed stuffing and loose buttons or screws.

Avoid buying toys with button batteries. Check the battery compartments on items in your home to make they’re secured. Keep loose button batteries out of reach.

Keep toys for small children and older siblings in separate boxes. Encourage older siblings to keep their little toys out of reach. This might include Lego, doll clothes, beads, car parts, and so on.

Precaution To Prevent Choking In Adults

If you think only small children choke on their food, you are mistaken. Adults can also experience problems that can result in fatal complications. Hence, adults need to follow the tips suggested below to avoid choking:

Eat Food At The Table

Many people tend to eat while they are lying down. It can only increase the chances of gagging on food. It is always advised to eat food while sitting on a chair at the table. An upright position during eating prevents the chances of food items getting stuck in the throat.

Cook Vegetables

Raw vegetable pieces can increase the chances of getting stuck in the throat. So, while you cook a vegetable, make sure they turn soft.

Cut Into Bite-Sized Pieces

You need to cut all food items, including the ones like hotdogs with more chances of gagging into bite-size pieces. Cut them into pieces half an inch or less. Also, cut them into round shapes. While eating, you need to take smaller amounts of food in your fork or spoon.

Encourage Chewing

Many people feel chewing is not important before swallowing food. In many cases, children and adults fail to chew food properly. It can increase the chances of gaging. So, make sure you chew food properly before swallowing.

Avoid Distractions

When you eat, avoid distractions such as watching TV or talking to others. When your attention shifts from eating, you can chew improperly. It can cause food to get stuck in the throat.

Avoid Drinking Liquid

While you are swallowing food, avoid drinking water or other liquid. If you want to drink water while eating, take only a smaller mouthful of water. People suffering from dysphagia, the problem causing swallowing problems must drink only thickened liquids.

Learn Life-Saving Techniques

To prepare yourself for such unexpected situations where your loved ones suffer from choking, you need to learn life-saving techniques. Learn the Heimlich maneuver and the CPR (Cardiopulmonary resuscitation) a necessity in the first-aid training course.

Conclusion

While eating food, you can develop an obstruction in the windpipe or esophagus. Due to food blockages, you can start coughing.  If the food blocks occur in the esophagus, it may not trigger any medical emergency. But, the blocks occurring in the windpipe can result in choking. It can lead to fatal complications when you fail to use life-saving techniques. Learning the Heimlich maneuver, commonly known as abdominal thrust can help you save lives. It is the first aid method used to remove the blockage from the windpipe of the affected person. But, this treatment may not work for babies under one year and heavily pregnant women. Emergency treatment is required for people suffering from gaging. Seeing a doctor will help diagnose the problem better. It will help get proper tips and techniques to enhance safety while swallowing.

References

https://kidshealth.org/en/parents/choking.html

https://www.mayoclinic.org/first-aid/first-aid-choking/basics/art-20056637#:~:text=Choking%20occurs%20when%20a%20foreign,aid%20as%20quickly%20as%20possible.

https://www.hopkinsmedicine.org/health/wellness-and-prevention/choking-and-the-heimlich-maneuver