Choking: Understanding the Condition and Effective First Aid Response

Choking epidemiology and condition

A person chokes when the airway is partly or completely blocked and airflow to the lungs is reduced or cut off. The choking casualty either has trouble breathing or cannot breathe at all.

Causes of choking

Foreign objects

• Infants and children—food, toys, buttons, coins, etc

• Adults— consuming drinks quickly with food in your mouth.

• In elderly people—food, pills

The tongue

• Infants and children-tongue falls to the back of the throat when lying on back.

• Adults-Saliva, blood or vomit pools in the throat.

Swelling

• Infants and children-Injury to the throat area causes swelling of the airways

• Adults-Illness causes swelling, e.g. allergic reaction, asthma, epiglottis, croup

Recognition

Ask:

“Are you choking?”

• Mild obstruction: Difficulty in speaking, coughing, and breathing

• Severe obstruction: Inability to speak, cough, or breathe

• Eventual unconsciousness

With good air exchange, the obstruction is mild and person can still cough forcefully, breathe and speak. With poor air exchange, the obstruction is severe and the person cannot cough forcefully, has trouble breathing, or cannot speak. With a completely blocked airway, there is no air exchange—coughing, breathing and speaking are impossible. When the air supply to the lungs is cut off, the person’s face immediately becomes red or “flushed”. Shortly after, as the oxygen in the body is used up, the face becomes grey and the lips and ear lobes become blue. The person then becomes unconscious and eventually the heart stops beating.

What to do

• Encourage causality to cough-If the casualty is breathing, encourage her to cough to try to remove the obstruction herself. If this fails, go to step

• Give abdominal thurst-Stand behind the casualty. Put both arms around her, and put one fist between her navel and the bottom of her breastbone. Grasp your fist with your other hand, and pull sharply inward and upward until the object is dislodged.

• Call the emergency for help- if the casualty loses consciousness, then begin CPR starting with chest compressions.

Self help

If you begin to choke on an object you may have to clear your own airway.

• If there are people around, get their attention, do not isolate yourself from others.

• Try to cough up the object.

• Give yourself abdominal thrusts until you can cough forcefully, breathe or speak.

A second method is to use a solid object like the back of a chair, a table or the edge of a counter.

• Position yourself so the object is just above your hips.

• Press forcefully to produce an abdominal thrust.