Choking

In adults, choking is often the result of inadequately chewed food becoming lodged in the throat or windpipe. Solid foods such as meat are frequently the cause.

These factors increase the risk of choking:

-Talking while simultaneously chewing a piece of meat.

-Drinking alcohol while eating.

-Wearing dentures. Because dentures exert less chewing pressure than natural teeth and they interfere with the way food feels in the mouth, they make it more difficult to thoroughly chew food.

Young children tend to put into their mouths almost anything that fits, so choking can occur unassociated with a meal.

-Panic accompanies choking. The choking victim's face often assumes an expression of fear or terror. At first the victim may turn purple, the eyes may bulge, and he or she may wheeze or gasp.

If the person can cough freely, has normal skin color and can speak, he or she is not choking. If the cough is more like a gasp and the person is turning blue, he or she is probably choking. If in doubt, ask the choking person if he or she can talk. If the person can speak, then the windpipe is not completely blocked and oxygen is reaching the lungs. If choking is occurring, begin to perform the Heimlich maneuver.

To perform the Heimlich maneuver on someone else:

-Stand behind the choking person and wrap your arms around his or her waist.

-Bend the person slightly forward.

-Make a fist with one hand and place it slightly above the person's navel.

-Grasp your fist with the other hand and press hard into the abdomen with a quick, upward thrust. Repeat this procedure until the object is expelled from the airway.

To perform the Heimlich maneuver on yourself:

-Position your own fist slightly above your navel.

-Grasp your fist with your 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:

-Position the person on his or her back, look inside the mouth and sweep the area with your finger to see if you can remove the blockage.

-If not, kneel over the person and apply upward thrusts to the upper abdomen.

-Repeat the process as necessary. Look inside the mouth again and sweep the area with your finger to try to remove the blockage. Then kneel over the person and apply upward thrusts to the upper abdomen.

Clearing the airway of a choking infant:

-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 mouth-to-mouth resuscitation.

The universal sign for choking is a hand clutched to the throat, with thumb and fingers extended. If a person displays this sign, dial 911 or call for emergency medical assistance. Don't leave the person unattended.

If some food "goes down the wrong pipe," the coughing reflex often will resolve the problem. If it doesn't, you'll need to help the victim remove the airway obstruction.

To prepare yourself for such situations, learn the Heimlich maneuver in a certified first-aid training course.