Choking symptom: Choking: First aid – Mayo Clinic

21.09.202327.06.2023 by alexxlab

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How to recognise the signs of choking

Written by: Bronwen Watson

What to do when someone is choking

How to recognise the signs of choking

What should your first response be?

How to care for an adult or child (over the age of 1) who is choking

How to care for an infant (baby) who is choking

How to perform the Heimlich Manoeuvre on yourself

While you wait for emergency services…

Choking risk factors to take into consideration

Safety considerations for administering first aid

The universal sign for choking is most typically a person immediately clutching their throat as soon as a foreign object becomes lodged. This is most often closely followed by intense panic. There are several other signs and symptoms to look out for in those critical moments, which relate to the type of airway obstruction (either partial or complete) that is being experienced.

1. Partial airway obstruction:

Noisy, gasping, wheezing, whistling or laboured breathing (stridor)

Ability to cough (this may be frantic, as well as weak)

Attempts to speak will result in difficulties with delivering complete sentences or being able to communicate at a normal / full volume

Watery eyes

Red (flushed) facial complexion

Extreme distress and anxiety (sometimes confusion)

Some air may escape from the mouth (indicating that there is some air movement)

2. Complete or total airway obstruction:

Inability to breathe (no air movement), speak, cough or even cry

Vigorous attempts to breathe (signs may be noted by in-drawn spaces between the ribs and above the collarbones)

Extreme distress, agitation and anxiety

Facial discolouration – flushed / pale / cyanosis (blue) – affecting the skin, lips and nails

Loss of consciousness

It’s important to recognise the type of airway obstruction being experienced as this has an effect on how you will go about caring for a person in the best way possible. A partial obstruction means that a little air is able to pass through the narrowed windpipe (although not comfortably). Breathing is strained and noisy, but some air is still capable of reaching and leaving the lungs.

Full, and hard back blows could worsen a person’s state and lead to total airway obstruction. In this instance, a choking person should rather be encouraged to try and cough in order to help expel the obstruction. If they are unable to do so, the Heimlich Manoeuvre can be used.

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Choking

Panic

Stridor

Wheezing

Cough

Flushed complexion

Watery eyes

Anxiety

Confusion

Noisy breathing

Breathing problems

Cyanosis

Loss of consciousness

adult or child over 1 year: MedlinePlus Medical Encyclopedia

Choking is when someone is having a very hard time breathing because food, a toy, or other object is blocking the throat or windpipe (airway).

A choking person’s airway may be blocked so that not enough oxygen reaches the lungs. Without oxygen, brain damage can occur in as little as 4 minutes. Rapid first aid for choking can save a person’s life.

Choking can be caused by any of the following:

Eating too fast, not chewing food well, or eating with dentures that do not fit well
Drinking alcohol (even a small amount of alcohol affects awareness)
Being unconscious and breathing in vomit
Breathing in small objects (young children)
Injury to the head and face (for example, swelling, bleeding, or a deformity can cause choking)
Swallowing problems after a stroke
Enlarged tonsils or tumors of the neck and throat
Problems with the esophagus (food pipe or swallowing tube)

When an older child or adult is choking, they will often grab their throat with the hand. If the person does not do this, look for these danger signs:

Inability to speak
Difficulty breathing
Noisy breathing or high-pitched sounds while inhaling
Weak, ineffective coughing
Bluish skin color (cyanosis)
Loss of consciousness (unresponsiveness) if blockage is not cleared

First ask, “Are you choking? Can you speak?” DO NOT perform first aid if the person is coughing forcefully and is able to speak. A strong cough can dislodge the object. Encourage the person to keep coughing to dislodge the object.

If the person cannot speak or is having a hard time breathing, you need to act fast to help the person. You can perform abdominal thrusts, back blows, or both.

To perform abdominal thrusts (Heimlich maneuver):

Stand behind the person and wrap your arms around the person’s waist. For a child, you may have to kneel.
Make a fist with one hand. Place the thumb side of your fist just above the person’s navel, well below the breastbone.
Grasp the fist tightly with your other hand.
Make a quick, upward and inward thrust with your fist.
Check if the object is dislodged.
Continue these thrusts until the object is dislodged or the person loses consciousness (see below).

To perform back blows:

Stand behind the person. For child, you may have to kneel.
Wrap one arm around to support the person’s upper body. Lean the person forward until the chest is about parallel to the ground.
Use the heel of your other hand to deliver a firm blow between the person’s shoulder blades.
Check if the object is dislodged.
Continue back blows until the object is dislodged or the person loses consciousness (see below).

To perform abdominal thrusts AND back blows (5-and-5 approach):

Give 5 back blows, as described above.
If the object is not dislodged, give 5 abdominal thrusts.
Keep performing the 5-and-5 until the object is dislodged or the person loses consciousness (see below).

IF THE PERSON FAINTS OR LOSES CONSCIOUSNESS

Lower the person to the floor.
Call 911 or the local emergency number or tell someone else to do so.
Begin CPR. Chest compressions may help dislodge the object. Abdominal thrusts are for a conscious choking victim. Chest compressions are for an unconscious choking victim.
If you see something blocking the airway and it is loose, try to remove it. If the object is lodged in the person’s throat, DO NOT try to grasp it. This can push the object farther into the airway.

FOR PREGNANT OR OBESE PEOPLE

Wrap your arms around the person’s CHEST.
Place your fist on the MIDDLE of the breastbone between the nipples.
Make firm, backward thrusts.

After removing the object that caused the choking, keep the person still and get medical help. Anyone who is choking should have a medical examination. Complications can occur not only from the choking, but also from the first aid measures that were taken.

DO NOT interfere if the person is coughing forcefully, is able to speak, or is able to breathe in and out adequately. But, be ready to act right away if the person’s symptoms get worse.
DO NOT force open the person’s mouth to try to grasp and pull out the object if the person is conscious. Perform abdominal thrusts and/or back blows to try to expel the object.

Seek medical help right away if you find someone unconscious.

When the person is choking:

Tell someone to call 911 or the local emergency number while you begin first aid/CPR.
If you are alone, shout for help and begin first aid/CPR.

After the object is successfully dislodged, the person should see a health care provider because complications can arise.

In the days following a choking episode, contact the provider right away if the person develops:

A cough that does not go away
Fever
Difficulty swallowing or speaking
Shortness of breath
Wheezing

The above signs may indicate:

The object entered the lung instead of being expelled
Injury to the voice box (larynx)

To prevent choking:

Eat slowly and chew food thoroughly.
Make sure dentures fit properly.
Do not drink too much alcohol before or during eating.
Keep small objects away from young children.

Abdominal thrusts – adult or child over 1 year; Heimlich maneuver – adult or child over 1 year; Choking – back blows – adult or child over 1 year

Choking first aid – adult or child over 1 year – series

American Red Cross. First Aid/CPR/AED Participant’s Manual. 2nd ed. Dallas, TX: American Red Cross; 2016. www.pdfdrive.com/american-red-cross-first-aidcpraed-d128296673.html. Accessed February 20, 2023.

Duff JP, Topjian AA, Berg MD, et al. 2019 American Heart Association focused update on pediatric basic life support: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Pediatrics. 2020;145(1):e20191358. PMID: 31727861 pubmed.ncbi.nlm.nih.gov/31727861/.

Easter JS. Pediatric resuscitation. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 158.

Goodloe JM, Soulek J. Foreign bodies. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 51.

Haas NL, Kurz MC. Adult resuscitation. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 5.

Kleinman ME, Goldberger ZD, Rea T, et al. 2017 American Heart Association focused update on adult basic life support and cardiopulmonary resuscitation quality: an update to the American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2018;137(1):e7-e13. PMID: 29114008 pubmed.ncbi.nlm.nih.gov/29114008/.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Asphyxiation, symptoms, treatment

Asphyxiation or asphyxia is a pathological condition characterized by a decrease in the level of oxygen in the blood and tissues of the body and an increase in carbon dioxide. Attacks of suffocation can develop acutely or subacutely and are accompanied by symptoms of respiratory failure. Signs of suffocation include:

Increased respiratory rate;
Cyanosis of coli and mucous membranes;
Participation in the process of respiration of additional muscles;
In the critical stage convulsions develop, consciousness is disturbed up to coma;
Death may occur as a result of respiratory and cardiac arrest.

Diagnosis and treatment may depend on the cause of suffocation, but in any case, this condition requires immediate medical attention. Asthma attacks can be caused by such diseases as bronchial asthma, allergic edema, bronchiolitis. In other cases, the causes of suffocation in the throat are traumatic injuries, craniocerebral disorders, poisoning, etc. What kind of disease – choking in the throat – can be diagnosed by analyzing complaints, collecting an anamnesis, conducting thorough research, etc. In real life, suffocation does not cause as much delight as Palahniuk’s books, but requires fast and accurate honey to restore breathing. Many people know Palahniuk’s quotes from the book “Suffocation”, but, sadly, they do not know how to provide assistance with asphyxia. Help for asphyxia may include:

Oxygen inhalation;
Conico- or tracheotomy;
Artificial lung ventilation;
Medical treatment, etc.

The Yusupov hospital provides assistance to patients around the clock. If it is necessary to provide assistance in case of asphyxia, the patient stays in the intensive care unit, which is equipped with all the necessary equipment, oxygen is centrally supplied, etc.

The cause of asthma attacks at night in the presence of bronchial asthma is often inadequate treatment. If the prescribed therapy helped to control the disease for a long time, but choking still appeared at night, it may be caused by the need to adjust the dose of drugs.

Doctors at the Yusupov Hospital will select the right and effective treatment, help you improve your standard of living and improve your prognosis. In the Yusupov hospital, the leisure of patients has been thought out, the best conditions have been created for the fastest possible recovery of patients.

Causes of suffocation

Causes of suffocation both during the day and at night are usually divided into pulmonary and extrapulmonary.

Pulmonary causes associated with either compression from the outside, or with a decrease in the lumen due to obturation. Compression associated with external pressure is seen with shibari strangulation, neck injuries, etc. Asphyxiation in the throat with intraluminal obstruction causes the ingress of a foreign object, endophytic tumors, the ingress of food, water, blood into the lumen of the bronchus.

Extrapulmonary causes of suffocation during sleep include:

Strokes;
Traumatic brain injury;
Circulatory disorders;
Poisoning;
Traumatic injuries, etc.

A feeling of lack of air at night can also be accompanied by decompensation of cardiovascular diseases. Establishing the cause of the development of a symptom allows the doctor to decide on the tactics of managing the patient.

Types of asphyxia are divided depending on the mechanism of its occurrence. Mechanical associated with compression, obstruction or spasm; with toxic – suffocation occurs as a result of a pathological effect on the respiratory center; traumatic – damage to the chest, etc.

Symptoms of suffocation

Asphyxia clinically goes through four phases.

In the first phase, the activity of the respiratory center increases compensatory and the patient experiences panic, dizziness, a feeling of suffocation in the throat, an increase in heart rate and blood pressure. If the cause of an attack of suffocation at night is the obstruction of the pathways, then a cough, distant wheezing, cyanosis of the face, etc. are also a sign.

When the compensatory forces are exhausted, the exhalation intensifies and lengthens, cyanosis increases, the frequency of respiratory movements decreases, the pulse and arterial pressure decrease. The clinical picture of the third phase is supplemented by the extinction of reflexes, episodes of apnea appear, consciousness is disturbed, up to coma. Convulsions, agonal breathing, it is almost impossible to determine the pulse and blood pressure – these are the characteristics of the fourth phase.

If the feeling of suffocation in the throat occurs gradually, then the patient assumes an orthopnea position, involuntarily increasing the volume of the chest. Signs of a feeling of suffocation will also be pallor of the skin with peripheral cyanosis.

Diagnosis of suffocation

If the patient is conscious in the first phase, the collection of complaints will already lead the specialist to a diagnosis. Pulse oximetry makes it possible to determine the level of oxygen saturation in the blood. To identify the cause, pulmonologists, endoscopists, traumatologists, neurologists, etc. are involved in the patient. If time allows, X-ray methods of examination, bronchoscopy, etc. are carried out.

If asphyxia is an acute threat to the patient’s life, it is necessary to provide assistance, and the cause is established after stabilization of his condition.

Acute suffocation

Mechanical asphyxia is treated with bronchoscopy, tracheal aspiration, retraction of the tongue, etc. If these measures did not lead to the restoration of breathing and cardiac activity, then it is necessary to immediately carry out cardiopulmonary resuscitation, followed by transfer to artificial ventilation of the lungs, if necessary.

If dyspnea is caused, for example, by hemothorax, first aid is to drain the pleural cavity or perform thoracocentesis.

Restoration of lung ventilation makes it possible to start medical treatment. Pathogenetic therapy is used in case of asphyxia of infectious, nervous and other etiology.

If suffocation progresses acutely, then there is a high risk of an unfavorable outcome, gradually developing asphyxia has a more favorable prognosis. The timeliness of assistance and its volume play an important role in the outcome. A patient who has suffered an attack of asphyxia often requires special care and counseling with dynamic monitoring from specialists in many areas.

Prevention of this condition consists in the treatment of the disease, which caused asphyxia.

The Yusupov hospital provides qualified medical care for any type of asphyxia. The Yusupov hospital operates around the clock. The hospital is equipped with modern equipment for diagnosis and treatment. The period of rehabilitation of patients takes place under the supervision of the best specialists according to European standards using unique techniques and effective simulators. The Yusupov Hospital is a unique medical institution staffed by professors, doctors of medical sciences, leading Russian specialists, etc. The hospital was the first to receive permission to conduct research activities. Only the best methods, techniques and preparations are used in the work. You can book a consultation online or by phone.

reasons, how to remove and give first aid, prevention at home

Asphyxiation attacks can frighten any person. The feeling of lack of air causes panic and fear of death, especially if it occurs at night. This symptom often signals a serious illness or condition that requires emergency medical attention.

We talked to our experts about the most common causes of choking in adults. We found out how to provide first aid for an asthma attack, and learned about modern methods of diagnosing and treating this condition.

Causes of asthma attacks in adults

Doctors call suffocation a feeling of lack of air, in which a person cannot take a full breath. This is a non-specific symptom that is observed in injuries and a number of diseases of the respiratory, cardiovascular, endocrine and nervous systems.

Depending on the cause, asthma attacks in adults occur episodically or may be single. Next, we will talk about the most common causes of suffocation in adults, preventive measures and first aid.

Sleep apnea

According to various sources, temporary (up to 10 seconds) cessation of breathing during sleep or sleep apnea occurs in 9-20% of adults ¹ . Respiratory arrest occurs against the background of diseases of the ENT organs and a decrease in the tone of the smooth muscles of the respiratory tract ¹ . In addition to temporary cessation of breathing, apnea is accompanied by snoring, frequent nocturnal awakenings and daytime sleepiness ¹ .

Asthma

This chronic inflammatory disease of the respiratory tract is characterized by periodic or regular attacks of breathlessness that occur during contact with an allergen, stress and physical exertion. During an attack, a person’s skin turns pale, lips turn blue, and wheezing or whistling is heard when exhaling. The attack ends with a strong cough with viscous sputum.

Chronic obstructive pulmonary disease

According to WHO, COPD is the 3rd leading cause of death in the world, behind only cardiovascular and oncological diseases ² . Patients with COPD have reduced bronchial patency and reduced airflow to the lungs ² . The disease is accompanied by chronic cough and shortness of breath. During periods of exacerbation, shortness of breath increases, can provoke attacks of suffocation and acute respiratory failure ² .

Cardiac asthma

Cardiac asthma or acute left ventricular failure is characterized by a decrease in myocardial contractility, stagnation of blood in the pulmonary circulation and acute respiratory failure ³ . During an attack of cardiac asthma, a person suffers from lack of air, increased diastolic blood pressure, tachycardia and dry cough ³ .

Quincke’s edema

Quincke’s edema is an allergic reaction that develops upon contact with an allergen (drug, food product, plant pollen) or under the influence of physical factors: cold, bright sunlight ⁴ . Usually lips, cheeks and eyelids swell, and in about 30% of cases – the larynx. With swelling of the larynx, first there is a “barking” cough, then hoarseness and suffocation ⁴ . Without medical attention, patients with angioedema can die from respiratory failure ⁴ .

Foreign body in the larynx

Foreign bodies most often enter the larynx during meals or when taking a sudden deep breath. It can be food, household items, medical instruments. Foreign bodies of large size and elastic structure, which block the lumen of the larynx and leave no room for air to pass, are especially dangerous. If a large foreign body is not removed within 7–9minutes, respiratory and cardiac arrest may occur.

Panic attack

Panic attack is a type of anxiety disorder that manifests itself in attacks of unmotivated fear. During the attacks, there is a rapid heartbeat, sweating and symptoms of suffocation. A panic attack does not pose a physical danger, but it seriously complicates a person’s daily life.

Epilepsy

Epilepsy is a chronic brain disease characterized by repeated seizures with temporary impairment of motor, sensory and mental functions ⁴ . With a generalized convulsive seizure, a person first experiences an increase in the tone of all muscles and a short-term cessation of breathing, and then convulsions that spontaneously stop after a few minutes ⁴ .

Treatment of asthma attacks in adults

Treatment of asthma attacks in adults is carried out by physicians of various specializations. Emergency care is usually provided by ambulance staff, surgeons and resuscitators. Therapists, neurologists, otolaryngologists, cardiologists, allergists and pulmonologists select tactics for treating the underlying disease that caused an asthma attack in an adult.

Patients undergo comprehensive diagnostics beforehand. An experienced doctor can determine the cause of suffocation by the clinical picture, but additional examinations are required to make an accurate diagnosis: laryngoscopy, bronchoscopy, ultrasound, CT, radiography, spirography.

How to relieve suffocation and give first aid to a person

First aid for an attack of suffocation often has to be done at home. It is better to lay the victim on his side and provide him with an influx of fresh air, for example, open his mouth. A sleeping person should be awakened so that the breathing becomes deeper. In the room where the sick person is, be sure to open the window. If these measures have worked, the victim’s chest will begin to rise freely on inspiration and fall on expiration without wheezing and other extraneous noises. People with angioedema should immediately call an ambulance, and then provide first aid – stop contact with the allergen, give an antihistamine ⁴ .

Modern methods of treatment

Tactics of treatment directly depends on the cause that caused an asthma attack in an adult. In emergency cases, surgical intervention and intensive care in a hospital are possible. But most often, the treatment of the underlying disease takes place on an outpatient basis using medications and apparatus methods:

patients with sleep apnea can be prescribed psychostimulant drugs and CPAP therapy using a device that creates additional air flow and expands the upper airways ¹ ;
for the treatment of bronchial asthma, glucocorticoid and non-steroidal anti-inflammatory drugs in the form of inhalations, leukotriene receptor antagonists, systemic glucocorticoids are usually used;
patients with epilepsy should take anticonvulsants and sedatives ^{2. 5} ;
with panic attacks, breathing exercises, cognitive-behavioral therapy and the use of “anti-anxiety” drugs – anxiolytics give good results;
patients with cardiac asthma are prescribed nitroglycerine, nifedipine, antihypertensive and diuretic drugs, cardiac glycosides for relief of attacks ⁵ .

Many patients with choking are prescribed oxygen therapy. This is the inhalation of a saturated oxygen mixture independently, and in severe cases – with the help of a ventilator. Oxygen therapy is indicated for a wide range of diseases that are accompanied by respiratory failure.

Prevention of asthma attacks in adults at home

Ideally, every home should have a pulse oximeter and an oxygen concentrator. A pulse oximeter measures the amount of oxygen in the blood. The concentrator produces an oxygenated air mixture that is used for inhalation. Inhalation of such a mixture prevents hypoxia in people with heart and respiratory failure and reduces the likelihood of asthma attacks.

For the prevention of asthma attacks, adults are advised to give up bad habits, especially smoking. People with a tendency to sleep apnea should exercise the muscles of the larynx – perform speech exercises or practice vocals ¹ . Patients with any chronic diseases should follow the doctor’s prescription and not ignore the medication. People who have had angioedema should avoid contact with the allergen, and if they are allergic to medications, report it every time they seek medical help ⁴ .