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Choking

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  3. Choking

Overview of Choking

Choking is the obstruction of airflow to the lungs that occurs when some foreign object more often enters food into the trachea (windpipe) instead of the esophagus (food pipe). Choking happens either by partial windpipe blockage or completely blocking the airways. If the foreign object is at the start of the trachea, then coughing will probably push it out. But if it crosses the trachea, avoid doing any procedure that will further push into the windpipe.

Choking blocks the oxygen supply to the brain. The brain can only survive for a few minutes without an oxygen supply.

A survey by Injury Fact Report (2017) stated that ‘Choking is at the fourth place of death caused by unintentional injury’.

It can be life-threatening!

You must know its symptoms and how to cope with it at home or at a public place in case of emergencies.  

Signs and Symptoms of Choking

Signs and symptoms of choking include;

  • Difficulty in speaking
  • High-pitched wheezing sound
  • Ineffective and weak cough
  • Cyanosis (skin color becomes bluish due to lack of oxygen)
  • Grabbing at throat
  • Loss consciousness
  • Unable to swallow further

Types of Choking

Choking is categorized into two types: 

  1. Complete obstruction

It occurs when an object enters the windpipe and blocks the airflow completely. It might create a wheezing sound as the victim cannot throw an object from his mouth. It needs assistance to expel the object by applying force on the abdomen (abdominal thrusts). In the case of pregnant women, chest thrust is recommended.      

  1. Partial Obstruction

It is the partial obstruction of airways. A normal cough can help in expelling the object from the mouth. Make sure that the casualty will cough enough to throw out the thing.

Causes of Choking

Causes of the chocking include:

  • Improper chewing of food
  • Talking or laughing while eating
  • Eating speedily without taking breaths
  • Large-sized food
  • Hard food material
  • The habit of putting small objects in the mouth (in small children)

What is choking sensation anxiety?

Choking or Globus sensation is not always linked with swallowing but also happens in some other diseases such as GERD, muscle disorders, and mental health problems. Choking sensation leads to anxiety. The persistent feeling of something stuck in your throat is often annoying and may stress you.

No need to worry about having choking sensation anxiety, you should talk with an ENT specialist. 

Happniness

Risk Factors of Choking

Risk Groups 

  • Young children
  • Infants
  • Old age people

Old people are more susceptible to choking as they lose some muscle reflexes required to expel food from the trachea. For example, patients with Parkinson's disease and Alzheimer’s disease.

  • Alcohol consumption (damage refluxes of windpipes)

Happniness

Prevention

You can prevent choking especially in children by keeping an eye on them while they play. Keep away all small objects from your children's access like coins, very small blocks, and erasers. A child’s food should be well-cooked, soft, and cut into small-sized pieces to make swallowing easy. Make sure they don’t talk while chewing food.

For adults, chew your food properly and eat slowly. You should keep water or liquid juice near you. Avoid talking while eating or chewing.

Happniness

Diagnosis

To confirm that airway blockage is due to choking, a doctor performs several tests which include; x-rays and bronchoscopy.

  • X-rays: It finds out the extent of blockage in the airways. The blockages seen on X-rays are known as Radiopaque. Radiopaque objects like coins, nails, etc. are visible through x-rays on the chest or neck.

  • Bronchoscopy: An instrument is inserted into the airways to look for foreign objects inside the airways. It has an attachment that can pull the object out.

Treatment of Choking | When to Consult a Doctor

Treatment of choking depends on the person's condition which includes abdominal thrust technique and CPR.

First aid treatment for choking

It is important for you to know what is the very first action whenever you see someone choking. If choking blocks the airway and the person is conscious then, ‘Abdominal thrusts’ are recommended. Abdominal thrust is performed in a series only when a person is in the senses. However, if a person loses consciousness under choking, then use ‘chest compression’.

The abdominal thrust causes the diaphragm to uplift, expelling air from the lungs that in turn make an artificial cough. A good cough can expel the object from the windpipe that would otherwise block the airways by moving down.

How to perform Abdominal Thrust?

  • Grasp around the person’s waist.
  • Make a fist of one hand and grasp it with your other hand.
  • Position the fist on the rib cage.
  • Press your fist upward and backward under the rib cage for six to ten times.
  • In case the victim is pregnant or obese, try chest compressions.
  • Continue this process until the choking is relieved. If the obstruction is not released, immediately consult the healthcare provider asap.

Apply abdominal thrust only in an emergency as it can be painful.

It’s better to use abdominal thrust in adults. Different techniques are applied to infants and children.

If the choking becomes unresponsive, apply CPR!

Cardiopulmonary resuscitation (CPR)

The procedure of CPR involves;

  • Place the victim to lie down on a hard surface or ground.
  • The chest is exposed
  • Gently tilt the victim’s head and uplift the chin to open airways
  • Close the nostrils
  • Give rescue breaths (2-3 breaths)
  • Compress the chest with your interlocked fingers so that only the heels of your hand make the pressure. Compress almost 30 times gently.
  • Continue this cycle i.e. rescue breath then compression, until the victim of choking wakes up.
  • Repeat cycles in a way that you will complete 5 cycles in one minute

How to perform first aid for choking on yourself?

  • Firstly, don’t panic. 
  • Make others’ attention to yourself so that you need help. 
  • Try to cough as much as you can. 
  • Gently take breaths in and out by holding something to create a good cough. Coughing can expel the obstructed object. 
  • Make sure don’t let anybody slap you on your back as this can cause the object to move down further by gravity.

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