Choking is the inability to breathe caused by a blocked, swollen, or constricted trachea. It is a medical emergency that can result in brain damage or death. During an episode of choking, air cannot reach the lungs, which results in reduced oxygenation in the blood and vital organs. If the airways are not quickly cleared, death follows. Choking affects people of all ages but is more common in children. Prevention and immediate treatment of choking can save thousands of lives every year.
Significance
According to the American Red Cross, more than 3,000 people die every year as a result of choking. The most common cause of nonfatal choking is food, which is estimated to account for nearly 70 percent of all choking cases presented in emergency departments across the country. This figure is staggering, especially considering choking on food is one of the most preventable forms of choking. Many people who choke are treated successfully and suffer no permanent effects, but others experience permanent brain, neurological, or other damage. Thousands die.
Types
There are four main types of choking: choking due to mechanical obstruction, due to throat swelling, due to strangulation, and due to obstructive sleep apnea. Choking caused by mechanical obstruction results from the blockage of a person's airway as a result of a foreign object, such as a marble or piece of food. Choking can also result from infection when the throat tissue swells shut and impedes breathing. This type of choking can also be caused by an allergic reaction. Strangulation occurs when an external pressure closes the trachea and prevents the intake of oxygen. Finally, obstructive sleep apnea causes choking during sleep when the tissues of the body obstruct the airways. This type of choking is most common in obese men and in those who sleep on their backs. Other risk factors for obstructive sleep apnea include smoking, lung disease, and heavy use of alcohol. Obstructive sleep apnea is the only type of smoking that is not considered a medical emergency, but it does require treatment by a physician.
Features
Choking, regardless of the cause or type, cuts off the air supply to the lungs and reduces blood oxygenation. Signs of a completely blocked airway include being unable to speak or ask for help, turning blue around the mouth or in the face from lack of oxygen, grabbing or clutching at the throat in an attempt to get help, and labored breathing that results in a high-pitched whistling sound. The next symptom is usually lack of consciousness. During an episode of obstructive sleep apnea, a person may gasp for air, stop breathing completely, or awaken suddenly, sometimes clutching the throat or chest. Daytime sleepiness is another common symptom of sleep apnea. In cases where choking is due to infection, other symptoms are generally present, such as fever and signs of illness. Severe allergic reactions may cause facial swelling or hives, but sometimes choking is the first symptom.
Warning
Choking, except during an episode of sleep apnea, is a medical emergency and requires immediate medical attention. Prolonged choking, even if the patient survives, may result in brain and neurological damage due to insufficient oxygen reaching the brain and other organs during a choking episode. An ambulance should be called immediately, should someone begin choking, and attempts to remove a foreign object from the throat should only be made if the object is clearly visible and accessible. If care is not taken when attempting to remove the foreign object and restore breathing, the object can be pushed further into the choking person's throat. This can make extraction more prolonged and complicated when medical help arrives.
Prevention/Solution
Choking prevention should be a concern in every household, especially in homes with older people and small children. According to the Centers for Disease Control and Prevention, babies under the age of one year are at the greatest risk of choking. Most cases of choking in young children are caused by food, and this cause is easily preventable. Children should be supervised at all times when eating and playing, and they should not be offered foods such as raisins, grapes, or slices of uncooked carrots or hot dogs. No child under the age of three should be given toys with small pieces, regardless of how advanced the child appears. Adults are at risk of choking on food also, and should avoid heavy alcohol consumption both during and before eating. Children and adults should avoid laughing and talking with full mouths. Avoiding alcohol, smoking, and sedatives before sleep can sometimes prevent choking caused by obstructive sleep apnea. Treatment of choking varies depending on the cause, but emergency medical assistance should be summoned at the first sign of choking. The Heimlich maneuver should be attempted on anyone choking on a foreign body. A tracheotomy is often performed by medical professionals at the scene before transport if the choking cannot be immediately resolved by some other means. Treatment of throat swelling caused by allergic reactions can sometimes be treated with medication. People with sleep apnea may receive a device to use during sleep that creates a positive airway pressure and provides a healthy mixture of air and oxygen.
Tags: sleep apnea, obstructive sleep apnea, obstructive sleep, choking food, foreign object, medical emergency