Choking can happen to people of all ages. It is when something is caught in the back of the throat. If the object (or food) blocks the top of the trachea a person may be unable to breathe. This is an emergency. It is also possible that food or other things can get stuck in the esophagus; while painful, this does not cause a person to stop breathing.
Certain medical conditions or circumstances can make a person more likely to choke.
Risk factors include, but not limited to:
- Children under the age of 5
- The elderly
- People with neurological illnesses
- People with disease that cause muscular degeneration, such as multiple sclerosis
- Disorders of the esophagus such as a narrowed esophagus due to chronic acid reflux
- People with anatomical genetic abnormalities that affect the swallowing process (cleft lip)
- People with injuries that affect the swallowing process
Certain activities or habits can also increase your risk of choking:
- Eating too quickly
- Not sitting down while eating
- Not chewing food properly
- Eating while lying down
Babies and young children like to put things in their mouths. Think about the things in your house that your child could choke on, and plan how you’ll keep them away from your child. The tips below can help you protect your child from choking:
Sit while eating. Your child is more likely to choke if he eats while running around or playing, so sitting at a table or even the floor will reduce the risk. If you sit with your child while he eats, and talk or entertain him, he’ll be less tempted to get up and run around.
Keep food pieces small. Until your child can chew well, give her food in pieces smaller than a pea. Anything bigger than this is hard for little children to eat safely. This is because their airways are small, and they’re still learning to chew and swallow properly.
Cook, grate or mash hard foods. Particularly hard fruit and vegetables like carrots and apples
Avoid nuts. Children can usually eat these safely at around three years of age, unless they have an allergy.
Keep small objects out of reach. Curiosity leads children to put unusual things into their mouths. Check the floor for small objects by getting down to child height and looking around.
Avoid toys with small parts, breakable parts, or brittle surfaces. Use toys that are solid and sturdy. Check toys for exposed stuffing and loose screws and buttons.
Keep toys for small children and older siblings in separate boxes. Encourage older siblings to keep their little toys out of reach. This might include Lego, doll clothes, beads, car parts and so on.
Supervision is one of the single more important factors to help prevent choking. One hundred percent supervision is usually not possible but should be implemented as much as possible when children under 5, elderly persons or a person with a history of swallowing difficulties is eating.
Approximately 60% of non-fatal choking hazards are caused by food items. Foods that are choking hazards are food that can be compressed to fit the size of the airway. Most food listed below should not be given to small children, elderly person or any individual who has difficulty swallowing, foods that are difficult to chew or are a size or shape that will easily become compressed.
Common Choking Hazards:
- Coins (18% of choking – related ED visits for children 1 to 4 years old)
- Small toys – some say that if an object can fit inside a roll of toilet paper your child can choke on it
- Latex balloons – leading cause of death in children under the age of 6
- Small balls
- Pen or marker caps
- Hotdogs – most common fatal food – related hazard
- Hard candies
- Raw carrots
- Hard Candy – (19% of choking – related emergency room visits)
- Nuts, seeds
- Un-popped popcorn
- Dried beans
What Should I Do If Someone is Choking?
Mild Choking: encourage them to cough
If the airway is only partly blocked, the person will usually be able to speak, cry, cough, or breathe. They will usually be able to clear the blockage themselves.
- To help with mild choking in an adult or child over one year old:
- Encourage the person to keep coughing to try to clear the blockage
- Ask the person to try to spit out the object if it’s in their mouth
- Don’t put your fingers in their mouth to help them as they may bite you accidentally.
Severe Choking: back blows and abdominal trusts
Where choking is severe, the person will not be able to speak, cry, cough, or breathe. Without help, they will eventually become unconscious.
To help an adult or child over one year old:
- Stand behind the person and slightly to one side. Support their chest with one hand. Lean the person forward so that the object blocking their airway will come out of their mouth, rather than moving further down.
- Give up to five sharp blows between the person’s shoulder blades with the heel of your hand. (the heel is between the palm of your hand and your wrist.)
- Check if the blockage has cleared
- If not, give up to five abdominal thrusts (explanation below)
Important: don’t give abdominal thrusts to babies under one year old or to pregnant women.
- Stand behind the person who is choking
- Place your arms around their waist and bend them forward
- Clench one fist and place it right above their belly button
- Put the other hand on top of your fist and pull sharply inwards and upwards
- Repeat this movement up to five times
- If the person’s airway is still blocked after trying back blows and abdominal thrusts, get help immediately.