choking

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Choking

 

Definition

Choking is the inability to breathe because the trachea is blocked, constricted, or swollen shut.

Description

Choking is a medical emergency. When a person is choking, air cannot reach the lungs. If the airways cannot be cleared, death follows rapidly.
Anyone can choke, but choking is more common in children than in adults. Choking is a common cause of accidental death in young children who are apt to put toys or coins in their mouths, then unintentionally inhale them. About 3,000 adults die each year from choking on food.
People also choke because infection causes the throat tissue to swell shut. It is believed that this is what caused George Washington's death. Allergic reactions can also cause the throat to swell shut. Acute allergic reactions are called anaphylactic reactions and may be fatal. Strangulation puts external pressure on the trachea causing another form of choking.
Finally, people can choke from obstructive sleep apnea. This is a condition where tissues of the body obstruct the airways during sleep. Sleep apnea is most common in obese men who sleep on their backs. Smoking, heavy alcohol use, lung diseases such as emphysema, and an inherited tendency toward a narrowed airway and throat all increase the risk of choking during sleep.

Causes and symptoms

There are three reasons why people choke. These are:
  • mechanical obstruction
  • tissue swelling
  • crushing of the trachea.
Regardless of the cause, choking cuts off the air supply to the lungs. Indications that a person's airway is blocked include:
  • the person cannot speak or cry out
  • the person's face turns blue from lack of oxygen
  • the person desperately grabs at his or her throat
  • the person has a weak cough and labored breathing that produces a high-pitched noise
  • the person has all of the above symptoms, then becomes unconscious
  • during sleep, the person has episodes of gasping, pauses in breathing, and sudden awakenings.

Diagnosis

Diagnosing choking due to mechanical obstruction is straightforward, since the symptoms are obvious even to an untrained person. In choking due to infection, the person, usually a child, will have a fever and signs of illness before labored breathing begins. If choking is due to an allergic reaction to medication or insect bites, the person's earlobes and face will swell, giving an external sign that internal swelling is also occurring.
Choking due to sleep apnea is usually diagnosed on reports of symptoms by the person's sleep partner. There are also alarm devices to detect the occurrence of sleep apnea. Eventually sleep may be interrupted so frequently that daytime drowsiness becomes a problem.

Treatment

Choking, except during sleep apnea, is a medical emergency. If choking is due to allergic reaction or infection, people should summon emergency help or go immediately to an emergency room. If choking is due to obstructed airways, the Heimlich maneuver (an emergency procedure in which a person is grasped from behind in order to forcefully expel the obstruction) should be performed immediately. In severe cases a tracheotomy (an incision into the trachea through the neck below the larynx) must be performed.
Patients who suffer airway obstruction during sleep can be treated with a device similar to an oxygen mask that creates positive airway pressure and delivers a mixture of oxygen and air.

Prognosis

Many people are treated successfully for choking with no permanent effects. However, if treatment is unsuccessful, the person dies from lack of oxygen. In cases where the airway is restored after the critical period passes, there may be permanent brain damage.

Prevention

Watching children carefully to keep them from putting foreign objects in their mouth and avoiding giving young children food like raisins, round slices of hot dogs, and grapes can reduce the chance of choking in children. Adults should avoid heavy alcohol consumption when eating and avoid talking and laughing with food in their mouths. The risk of obstructive sleep apnea choking can be reduced by avoiding alcohol, tobacco smoking, tranquilizers, and sedatives before bed.

Resources

Organizations

American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300. http://www.americanheart.org.

Key terms

Trachea — The windpipe. A tube extending from below the voice box into the chest where it splits into two branches, the bronchi, that go to each lung.
Tracheotomy — The surgical creation of an opening in the trachea that functions as an alternative airway so that the patient may breathe.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.

chok·ing

pnigophobia.
Farlex Partner Medical Dictionary © Farlex 2012

chok·ing

(chōk'ing)
Upper airway obstruction resulting from a foreign object in the trachea or oropharynx, laryngeal spasm or edema, or external compression of the neck. A life-threatening situation such as asphyxia, hypoxia, and death may occur if the victim is unable to clear the airway by coughing. The inability to speak indicates a complete airway obstruction. The universal sign for choking is the grasping of the throat by the person choking.
See also: Heimlich maneuver
Medical Dictionary for the Health Professions and Nursing © Farlex 2012

choking

Partial or total obstruction of the main air passage (the LARYNX or TRACHEA) by foreign body or external pressure. This induces a protective COUGH response which often clears the obstruction.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
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Amanda Whittington's story of how four bored women fish filleters from Hull spend a day at the races is chokingly funny at times.
If you didn't know better, there was almost a tear to be seen in Kerr's eyes as he chokingly spoke of the past 32 months in his "dream job".
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On the evening we were there, a lone Scottish piper joined the lament and flags representing the British and Belgian Legions dipped in a chokingly emotional tribute to the fallen.
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Steeped in the breath of ale and cigarettes, in the boozy and sometimes self-destructively proud nature of working class male friendships, it's a film for men of a certain age, one to catch them chokingly offguard as thoughts of time being called rush in unbidden, but its tears and tenderness should catch the heart of everyone who sees it.Mike Davies