Health Care and Choking

Choking is the mechanical obstruction of the flow of air from the environment into the lungs. Choking prevents breathing, and can be partial or complete, with partial choking allowing some, although inadequate, flow of air into the lungs. Prolonged or complete choking results in asphyxia which leads to anoxia and is potentially fatal. Oxygen stored in the blood and lungs keep the victim alive for several minutes after breathing is stopped completely; but unless the choking issue has been resolved and life saving measures have been implemented in time, you could die.

According to the Harvard Medical School Family Health Guide, a person who is choking will instinctively grab at the throat. The person also may panic, gasp for breath, turn blue, or be unconscious. If the person can cough or speak, he or she is getting air. Nothing should be done. If the person cannot cough or speak, begin the Heimlich maneuver immediately to dislodge the object blocking the windpipe.

The Heimlich maneuver creates an artificial cough by forcing the diaphragm up toward the lungs.  If you are choking and alone, you can perform the Heimlich maneuver on yourself by giving yourself abdominal thrusts. Or position yourself over the back of a chair or against a railing or counter and press forcefully enough into it so that the thrust dislodges the object. See more info on this topic at this site: http://www.health.harvard.edu/fhg/firstaid/choking.shtml .

Choking and suffocation is the third leading cause of home and community death in the United States, according to the National Safety Council. Foods are responsible for most choking incidents. But for children, objects such as small toys, coins, nuts or marbles can get caught in their throats. Choking can cause a simple coughing fit or something more serious like a complete block in the airway, which can lead to death. Although choking can occur in people of all ages, children under the age of three are particularly vulnerable. Older adults also have an increased risk of choking on food. More details can be found at their site: http://www.nsc.org/safety_home/HomeandRecreationalSafety/Pages/Choking.aspx .

To understand choking, you first have to understand what goes on at the back of your throat hundreds of times per day. All the food you eat and the air you breathe passes through your throat to get into your body. Food and liquid go down one pipe — the esophagus— to your stomach. Air goes down another pipe — the trachea or windpipe — to your lungs. These two pipes share an opening at the back of your throat, according to KidsHealth.org.

So if they share an opening, how does the food know which pipe to go down? Lucky for you, your body has it all under control. A little flap of cartilage called the epiglottis sits near your trachea, and every time you swallow, it springs into action. Acting like a little door, it closes off the entrance to your trachea so that food is sent down your esophagus into your stomach instead of into your lungs.

But every once in a while, especially if you are laughing while you are eating, the epiglottis doesn't close in time. A piece of food can slip down into the trachea. Most of the time, it's no big deal. Your body makes you cough and forces it back up. Here are four great ways to prevent choking:

·         Be extra careful when eating certain foods that are easy to choke on. They include things like: hot dogs, nuts, grapes, raw carrots, popcorn, and hard or gooey candy. Check food labels to make sure the food isn't the kind that can lead to choking.

·         Sit down, take small bites, and don't talk or laugh with your mouth full! And more than good manners are at stake. Following that advice will help prevent choking.

·         Look out for the little guys — and girls. Babies and toddlers love to put things in their mouths, so help keep them safe by picking up anything off the floor that might be dangerous to swallow — like deflated balloons, pen caps, coins, beads, and batteries. Keep toys with small parts out of reach.

·         Learn the Heimlich maneuver. It's usually taught as part of any basic first-aid course — the kind that might be held by the Red Cross, the YMCA, the American Heart Association, schools, or hospitals in your community. Who knows? You could be a lifesaver someday!

The body needs oxygen to stay alive. When oxygen can't reach the lungs and the brain, a person can become unconscious, sustain brain damage, and even die within minutes. That's what makes choking such a serious emergency. More info can be found at this website: http://kidshealth.org/kid/watch/er/choking.html# .

Choking can be prevented, according to HealthyChildren.org. Food accounts for over 50% of choking episodes. Be alert for small objects that can cause choking. Check under furniture and between cushions for small items that children could find and put in their mouths. Toys are designed to be used by children within a certain age range. Age guidelines take into account the safety of a toy based on any possible choking hazard. Don’t let young children play with toys designed for older children. Latex balloons are also a choking hazard. If a child bites a balloon and takes a breath, he could suck it into his airway. More details can be found here: http://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspx

If you encounter a conscious, choking individual that is coughing, encourage continued coughing. The Red Cross has a great overview of how to help someone who is choking: http://www.redcross.org/flash/brr/English-html/conscious-choking.asp .

If an adult is choking, you may, according to eMedicineHealth.com, observe the following behaviors:

• Coughing or gagging
• Hand signals and panic (sometimes pointing to the throat)
• Sudden inability to talk
• Clutching the throat: The natural response to choking is to grab the throat with one or both hands. This is the universal choking sign and a way of telling people around you that you are choking.
• Wheezing
• Passing out
• Turning blue: Cyanosis, a blue coloring to the skin, can be seen earliest around the face, lips, and fingernail beds. You may see this, but other critical choking signs would appear first.

If an infant is choking, more attention must be paid to an infant's behavior. They cannot be taught the universal choking sign.

• Difficulty breathing
• Weak cry, weak cough, or both

Choking is a true medical emergency that requires fast, appropriate action by anyone available. Emergency medical teams may not arrive in time to save a choking person's life. Much more detailed information about choking can be found at this site: http://www.emedicinehealth.com/choking/article_em.htm .

Choking can be dangerous, and should not be taken lightly by anyone. Children, senior citizens, and those with certain physical handicaps should always be on your watch list to keep safe from the dangers from choking. And, make sure you know how to call for help, and learn how to use the Heimlich manuever.

Until next time.