Instances of choking occur every day across our country, accounting for approximately 4,000-5,000 deaths per year. Children have the highest risk of choking, but we are seeing an increase in recent years of deaths from choking in the elderly (particularly over age 80). Food is, by and large, the most frequent culprit across all age ranges, but other objects can cause a problem as well. Recognizing someone choking and being able to intervene could save a person’s life.
The anatomy of the human throat is designed to prevent choking. In the back of the throat are two passageways: the esophagus (food tube) and the trachea (air/breathing tube). When we swallow, a flap of cartilage, called the epiglottis, closes over the trachea so that food or liquids cannot enter the trachea, causing choking.
However, if something happens quickly, like laughing or taking a sudden breath, the epiglottis cannot close quickly enough, and food or objects enter the airway and become lodged. Coughing is the reflex that allows us to remove a partial obstruction caused by food or an object. But when the object totally obstructs the airway, we cannot move air in or out, and intervention by another person will be needed.
How to Help Someone Who’s Choking
Relief of an obstructive airway is something that is taught in all CPR classes, but you have to recognize that someone is choking before you can help them. The universal sign for choking putting your hands to your throat. If you think someone is choking, ask the person if they can talk. To talk, we need to have the ability to move air. If they can talk, we know the person has a partial obstruction. If they cannot talk, you are likely dealing with a totally obstructed airway.
Actions to assist the person should be:
- Have someone call for help. The call can always be cancelled if the obstruction clears, but time is of the essence. Shave minutes!
- If the person has the ability to cough, allow them to do so and do not intervene. Most instances of choking can be cleared if the person can cough.
- If the person does not have the ability to cough or move air, perform the Heimlich maneuver. The Heimlich is basically using the air that is trapped in the lungs to force the object out.
Performing the Heimlich Maneuver
Not sure how to perform the Heimlich maneuver? Here’s how it’s done:
- Stand directly behind the person.
- Extend your arms around them, and grasp just below the tip of the sternum, or breastbone. Lock your hands together.
- In a quick motion, compress the abdomen by forcing your hands inward and upward.
As in so many potential hazards to our health, prevention is best. This includes:
- Keeping small objects away from infants and toddlers. Children of this age range learn texture through their mouth, so everything goes there. Police the area around a child continuously to make sure there is not anything small enough to get in their airway.
- Hot dogs and grapes are the two most common food items that children choke on, so prepping these foods for kids is imperative. Cut these items lengthwise instead of horizontally to avoid cylinder-type shapes that can easily lodge in the airway.
- Encourage kids to sit and eat, taking small bites. They should be taught to chew and swallow their food before talking.
- Never put objects such as pins, nails, etc., in your mouth for quick access.
- Eat slowly, taking small bites that can be chewed thoroughly and swallowed.
- If you are having trouble swallowing or are choking frequently on liquids, see your doctor.
A final recommendation: If you have not ever taken a basic life support course and learned how to do the Heimlich maneuver and CPR, please do so. Classes are available almost everywhere at local healthcare agencies and the Red Cross, so enroll in one today. The life you save may be someone you love.
Diane Simon, RN, CEN is the Trauma Coordinator/Registrar for ProMedica Defiance Regional Hospital.