| Subject | Contents |
| Definition | This condition is the inability to breathe due to a blockage in the airway (throat or windpipe). |
| Alternative Names | Heimlich maneuver - conscious adult or child over 1 year |
| Considerations | Coughing is the body's way of trying to remove a foreign object (such as food) from the airway. If coughing does not clear the obstruction, then choking occurs. A choking person's airway may be completely or partially blocked. A complete obstruction is immediately life-threatening. A partial obstruction can become life threatening if the person's ability to breathe in and out is sufficiently compromised. Treat any significant obstruction as a complete obstruction. Without oxygen, permanent brain damage can occur in as little as 4 minutes. Rapid first aid for choking can save a life. All choking victims should receive medical attention after the episode, since complications can arise, even if the object is successfully dislodged. Occasionally an object will enter the lung instead of being expelled. While the victim may appear to improve and breathe normally, in a few days signs and symptoms of a foreign body in the lung (such as wheezing , persistent cough , and pneumonia ) may develop. If this happens, get medical help immediately. |
| Causes | Eating (especially eating too fast, failing to chew food well enough, or eating with improperly fitted dentures) Alcohol consumption (even a small amount of alcohol affects awareness) Unconscious or stuporous persons may aspirate (inhale) vomited material Small objects aspirated (inhaled) by young children Trauma to the head and face (swelling or blood can cause choking ) |
| Symptoms | Grabbing the throat with the hand (the "universal distress signal" for choking ) Difficulty speaking or inability to speak Sudden wheezing or gagging Weak, ineffective coughing ; noisy breathing; high-pitched crowing sounds If the obstruction persists, loss of consciousness (due to lack of oxygen) may occur |
| First Aid | 1. Confirm that the airway is obstructed. Only initiate the following steps if the victim is unable to speak or cough, or can do so only weakly. Ask the victim, "Are you choking? Can you speak?" 2. Stand behind the victim and wrap your arms around his or her waist (or around the chest if the person is pregnant or very obese ). 3. Make a fist. Place the thumb side of your fist in the middle of the victim's abdomen, just above the navel and well below the tip of their breastbone (or on the middle of the victim's breastbone if the victim is pregnant or very obese). 4. Grasp the fist with your other hand. 5. Keep your elbows out and press your fist abruptly into the victim's abdomen using an upward and inward thrust (or straight backward if positioned over the breastbone of a pregnant or very obese victim). 6. Continue these thrusts until the object is dislodged or the victim loses consciousness. 7. If the victim loses consciousness, give first aid for an unconscious victim. |
| Do Not | DO NOT interfere if the victim is coughing forcefully, able to speak, or is able to breathe in and out. However, be ready to act immediately if the victim's symptoms worsen. DO NOT try to grasp an object that is lodged in a victim's throat. This might push it farther down the airway. |
| Call immediately for emergency medical assistance if | If you are not alone, have one person call the local emergency number while another person begins first aid. If you are alone, shout for help, and begin first aid. Even if you successfully dislodge the obstruction and the victim seems fine, he or she should receive medical attention after the episode. |
| Prevention | Eat slowly and chew food thoroughly Make sure dentures fit properly Avoid excessive alcohol consumption before or during eating Keep small objects away from young children |
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