Choking

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For choking meaning compression of the neck, see Strangling. For other usage of choking, see choke.

Choking is the obstruction of the flow of air from the environment into the lungs. Choking prevents breathing, and can be partial or complete, where partial choking indicates that there is some, although inadequate flow of air into the lungs. Prolonged or complete choking results in asphyxiation. Choking can be caused by:

• Introduction of a foreign object into the airway, usually involving the pharynx, larynx or trachea.
• Respiratory diseases that involve obstruction of the airway.
• Compression of the laryngopharynx, larynx or trachea in strangles.
• Smothering in cases of violence or accidents.

Foreign objects

Foreign objects obstructing the airway are a typical cause of choking. The situation can sometimes be relieved by strikes to the back while the person choking is leaning forward, or by abdominal thrusts (commonly known as the Heimlich Maneuver). Failure to cough up the object will, depending on the degree of choking, rapidly result in unconsciousness and cardiac arrest. The advanced medical procedure to remove such objects is inspection of the airway with a laryngoscope or bronchoscope, and removal of the object under direct vision, followed by CPR. Severe cases where there is an inability to remove the object may require cricothyrotomy.

First aid

There are different protocols for adults and children. Adults first start with encouraging to cough, where the patient is encouraged to cough in hope of dislodging the object Secondly once the casuality is too tired to cough anymore upto ten back slaps can be given. thirdly the heimlich maneuver is to be performed. (see below) last if the person falls to the floor uncoinsiouse the CPR will be performed. To perform the Heimlich maneuver on someone else:

• Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
• Make a fist with one hand. Position it slightly above the person's navel.
• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
• Repeat until the blockage is dislodged.

To perform the Heimlich maneuver on yourself:

• Place a fist slightly above your navel.
• Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
• Shove your fist inward and upward.

Clearing the airway of a pregnant woman or obese person:

• Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.
• Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.
• Repeat until the food or other blockage is dislodged or the person becomes unconscious.

Clearing the airway of an unconscious person:

• Lower the person on his or her back onto the floor.
• Clear the airway. If there is a visible blockage at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.
• If the object remains lodged and the person doesn't respond after you take the above measures, begin cardiopulmonary resuscitation (CPR). The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.

Clearing the airway of a choking infant younger than age 1:

• Assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh.
• Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object.
• If this doesn't work, hold the infant faceup on your forearm with the head lower than the trunk. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions.
• If breathing doesn't resume, repeat the back blows and chest thrusts. Call for emergency medical help.
• If one of these techniques opens the airway but the infant doesn't resume breathing, begin infant CPR.

Choking victims

• Subroto Mukerjee, the Father of the Indian Airforce, died by choking.
• Jimmie Foxx, a famous Major League Baseball player, also died by choking.

References

External links

• Choking. (PDF Format). Contains further information on preventing choking in small children.
• Choking. Contains information on procedures to alleviate choking in different cases.