What are the most effective first aid techniques for choking emergencies. How can you prevent choking incidents in adults and children. What steps should you take if someone is choking.

Understanding Choking: Causes and Consequences

Choking occurs when a foreign object, typically food, becomes lodged in the airway, obstructing the flow of oxygen to the lungs and brain. This medical emergency can have severe consequences if not addressed promptly. How long can the brain survive without oxygen during a choking incident. Brain damage or death may occur after just four minutes of oxygen deprivation.

Why is it crucial for everyone to be familiar with choking first aid techniques. Knowledge of proper choking response can mean the difference between life and death in emergency situations. By understanding the causes, recognizing the signs, and knowing how to respond, individuals can potentially save lives both at home and in public settings.

Recognizing the Signs of Choking

Identifying a choking victim quickly is essential for providing timely assistance. What are the telltale signs of choking. A person who is choking may exhibit the following symptoms:

• Inability to speak, cough, or breathe
• Clutching at the throat
• Panicked or distressed facial expressions
• Skin, lips, or nails turning blue due to lack of oxygen
• Loss of consciousness (in severe cases)

How can you differentiate between mild and severe choking. In cases of mild choking, the person may still be able to speak, cough, or breathe to some extent. Severe choking involves a complete blockage of the airway, requiring immediate intervention.

First Aid Techniques for Choking Adults

When faced with a choking adult, what is the recommended first aid approach. Experts advise using a combination of back blows and abdominal thrusts, also known as the Heimlich maneuver, for conscious adults and children over one year old.

Back Blows Technique

1. Stand behind the person and slightly to one side.
2. Support their chest with one hand and lean them forward so the upper body is parallel to the ground.
3. Give up to 5 sharp blows between the shoulder blades with the heel of your hand.

Abdominal Thrusts (Heimlich Maneuver)

1. Stand behind the person and wrap your arms around their waist.
2. Make a fist with one hand and place it just above the person’s navel.
3. Grasp your fist with the other hand and pull sharply inwards and upwards.
4. Repeat up to 5 times.

How do these techniques work to dislodge the obstruction. Back blows create vibrations that can help loosen the stuck object, while abdominal thrusts force air from the lungs, creating an artificial cough to expel the obstruction.

Choking First Aid for Special Situations

Are there modifications to the standard choking first aid techniques for certain groups of people. Yes, alternative approaches may be necessary in some cases:

Pregnant Women and Obese Individuals

For pregnant women in their third trimester or obese individuals, chest thrusts are recommended instead of abdominal thrusts. How are chest thrusts performed. Place your hands at the base of the breastbone and deliver quick, inward thrusts.

Self-Administered First Aid

What can you do if you’re alone and choking. You can perform abdominal thrusts on yourself by pressing your abdomen quickly against the back of a chair, edge of a counter, or other firm object.

Unconscious Choking Victims

If the person loses consciousness, what should you do. Begin CPR immediately and call for emergency services. The chest compressions used in CPR may help dislodge the obstruction.

Preventing Choking Incidents in Adults

While knowing how to respond to choking is crucial, prevention is equally important. What measures can adults take to reduce their risk of choking?

• Cut food into small, manageable pieces
• Chew thoroughly, especially if wearing dentures
• Avoid talking or laughing while eating
• Limit alcohol consumption before and during meals
• Be cautious with foods known to pose choking risks, such as hot dogs, grapes, and hard candies

How can mindful eating habits contribute to choking prevention? By taking the time to eat slowly and focusing on proper chewing, individuals can significantly reduce their risk of choking on food.

Choking Prevention Strategies for Children

Children, especially those under four years old, are particularly vulnerable to choking hazards. What steps can parents and caregivers take to protect children from choking incidents?

• Keep small objects out of reach (e.g., marbles, coins, small toys)
• Supervise mealtimes closely
• Cut food into small, age-appropriate pieces
• Avoid giving high-risk foods to young children (e.g., whole grapes, nuts, hard candies)
• Teach children to sit still while eating and to chew their food thoroughly
• Educate older siblings about not giving dangerous items to younger children

Why is it important to be aware of age-specific choking hazards? Different age groups face unique risks, and understanding these can help caregivers create safer environments for children of all ages.

Importance of First Aid Training and Education

While reading about choking first aid is valuable, hands-on training can provide crucial skills and confidence. How can individuals gain practical experience in choking first aid techniques?

• Attend first aid and CPR classes offered by organizations like the American Red Cross or American Heart Association
• Participate in workplace safety training programs
• Practice with approved choking manikins under professional guidance
• Regularly review and refresh first aid knowledge and skills

Why is ongoing education in first aid important? Emergency situations can be stressful, and regular training helps individuals respond calmly and effectively when every second counts.

Legal and Ethical Considerations in Choking First Aid

When providing assistance to a choking victim, it’s important to be aware of legal and ethical implications. What protections exist for individuals who offer help in emergency situations?

Many regions have “Good Samaritan” laws that protect individuals who provide reasonable assistance in good faith during emergencies. These laws are designed to encourage bystanders to help without fear of legal repercussions if something goes wrong.

Are there any situations where you should not attempt to help a choking person? While the instinct to help is admirable, it’s crucial to assess the situation carefully. If the person is still able to cough forcefully, it’s often best to encourage them to continue coughing while monitoring their condition. Additionally, if you’re not trained in first aid techniques, attempting certain maneuvers could potentially cause harm.

Consent and Communication

How should you approach a choking victim to offer assistance? Always ask for the person’s permission before intervening, if possible. Clear communication is key – explain what you’re going to do and reassure them. If the person refuses help but you believe their life is in danger, you may need to act against their wishes, but be prepared to explain your actions to emergency responders.

Documentation and Follow-up

What should you do after a choking incident has been resolved? It’s advisable to document what happened, including the actions taken and the person’s response. Encourage the individual to seek medical attention, even if they seem fine, as complications can sometimes arise later.

By understanding these legal and ethical considerations, individuals can feel more confident in their ability to provide assistance while respecting the rights and dignity of those in need.

Innovations in Choking Prevention and Response

As medical knowledge and technology advance, new approaches to choking prevention and response are emerging. What recent innovations are helping to address choking hazards?

Smart Food Preparation Devices

How are technological advancements improving food safety? New kitchen gadgets are being developed to help prepare food in ways that reduce choking risks. For example, specialized grape cutters quickly slice grapes into safe, quarter-sized pieces, while smart food processors can be programmed to achieve the ideal texture for different age groups.

Wearable Choking Detection Devices

Can technology help detect choking incidents? Researchers are working on wearable devices that can detect the physiological signs of choking, such as changes in breathing patterns or skin color. These devices could potentially alert caregivers or emergency services automatically when a choking incident occurs.

Advanced Airway Clearance Tools

Are there new tools available for clearing airway obstructions? Several innovative devices have been developed to assist in dislodging foreign objects from the airway. These include suction-based tools and specialized plunger-like devices designed to create negative pressure in the airway, potentially making it easier to remove obstructions.

While these innovations show promise, it’s important to note that they are not substitutes for proper first aid training and quick action in emergency situations. Traditional methods like back blows and abdominal thrusts remain the primary recommended techniques for responding to choking incidents.

Cultural and Dietary Factors in Choking Risk

Choking risks can vary across different cultures due to diverse dietary habits and food preparation methods. How do cultural factors influence choking incidents and prevention strategies?

Traditional Foods and Preparation Methods

Some traditional foods may pose higher choking risks due to their texture or the way they’re typically consumed. For example, mochi, a sticky rice cake popular in Japan, has been associated with choking incidents, particularly among elderly individuals. Understanding these cultural food practices can help tailor prevention strategies and public health messages.

Eating Customs and Social Norms

How do dining customs affect choking risk? In some cultures, eating quickly is considered polite or necessary due to short lunch breaks, potentially increasing the risk of choking. Conversely, cultures that emphasize slow, mindful eating may naturally reduce choking incidents. Recognizing these social norms can inform more effective choking prevention campaigns.

Age-Related Dietary Practices

Different cultures have varying approaches to introducing solid foods to infants and feeding elderly individuals. How do these practices impact choking risk? Understanding cultural norms around feeding different age groups can help healthcare providers offer culturally sensitive and effective choking prevention advice.

By considering these cultural factors, public health officials and educators can develop more targeted and effective strategies for choking prevention and first aid education across diverse communities.

The Role of Medical Professionals in Choking Prevention and Education

Healthcare providers play a crucial role in preventing choking incidents and educating the public about proper response techniques. How can medical professionals contribute to reducing choking risks and improving outcomes?

Patient Education

What information should healthcare providers share with patients to prevent choking? During routine check-ups, doctors and nurses can offer tailored advice on choking prevention, particularly for high-risk groups such as the elderly, young children, and individuals with swallowing difficulties. This may include dietary recommendations, safe eating practices, and home safety tips.

Swallowing Assessments and Interventions

For patients with medical conditions that affect swallowing, how can healthcare providers help reduce choking risk? Speech and language therapists, along with other specialists, can conduct thorough swallowing assessments and recommend appropriate interventions. These may include modified diets, swallowing exercises, or the use of adaptive eating utensils.

Community Outreach and Training

How can medical professionals extend their impact beyond individual patient care? By participating in community health fairs, offering workshops, or collaborating with local organizations, healthcare providers can reach a broader audience with important choking prevention and first aid information. This outreach is particularly valuable in areas where formal first aid training may be less accessible.

Research and Policy Advocacy

What role do medical professionals play in advancing choking prevention strategies? Through research and advocacy, healthcare providers can contribute to the development of evidence-based guidelines for choking prevention and response. This work can inform public policy, product safety standards, and healthcare practices to reduce choking incidents on a broader scale.

By leveraging their expertise and position of trust in the community, medical professionals can significantly contribute to reducing choking risks and improving emergency response outcomes.

Long-Term Effects and Recovery After Choking Incidents

While the immediate danger of a choking incident may pass quickly, there can be lasting physical and psychological effects. What should individuals and caregivers be aware of following a choking emergency?

Physical Complications

Can choking incidents cause ongoing health issues? In some cases, yes. Potential physical complications may include:

• Aspiration pneumonia from inhaling food or liquid into the lungs
• Damage to the throat or esophagus from the lodged object or first aid maneuvers
• Respiratory issues due to prolonged oxygen deprivation

It’s crucial for individuals who have experienced a severe choking incident to undergo a medical evaluation, even if they seem fine initially. This can help detect and address any hidden injuries or complications.

Psychological Impact

How can a choking incident affect mental health? The traumatic nature of a choking emergency can lead to psychological effects such as:

• Anxiety or fear around eating
• Post-traumatic stress symptoms
• Decreased confidence in social dining situations

Both choking victims and witnesses, particularly if they provided first aid, may benefit from psychological support to process the experience and develop coping strategies.

Recovery and Rehabilitation

What steps might be involved in recovering from a serious choking incident? Depending on the severity and any resulting complications, recovery may involve:

• Speech and swallowing therapy
• Dietary modifications and gradual reintroduction of certain foods
• Respiratory therapy if lung function was affected
• Counseling or support groups to address psychological impacts

Healthcare providers can develop personalized recovery plans to address both the physical and emotional aspects of healing after a choking emergency.

Long-Term Prevention Strategies

How can individuals use their experience to prevent future incidents? After a choking emergency, it’s important to:

• Reassess and modify eating habits as necessary
• Identify and address any underlying medical conditions that may increase choking risk
• Ensure all household members and regular caregivers are trained in choking first aid
• Consider using adaptive eating tools if recommended by healthcare professionals

By understanding and addressing the potential long-term effects of choking incidents, individuals and their support networks can work towards full recovery and implement strategies to prevent future occurrences.

Choking: First Aid and Prevention

When food or some other foreign object
becomes stuck in the airway it can cause choking. Choking prevents oxygen from getting
to
the lungs and the brain. Lack of oxygen to the brain for more than 4 minutes may cause
brain damage or death. It’s important for all people to recognize and know how to
handle
choking at home and in public places. Experts advise using back blows and abdominal
thrusts
to treat an adult or child over age one year who is choking.

How can I prevent choking?

You can prevent choking in adults
with these safety measures:

• Cut food into small pieces.

• Chew food slowly and thoroughly, especially if wearing dentures.

• Don’t laugh and talk while
  chewing and swallowing.

• Don’t drink lots of alcohol
  before and during meals.

You can prevent choking in children
with these safety measures:

• Keep marbles, beads, thumbtacks, latex balloons, coins, and other small toys and objects
  out of reach, particularly in children younger than 4 years old.

• Prevent children from walking, running, or playing when they have food and toys in
  their mouth.

• Don’t feed children younger
  than age 4 foods that can easily get lodged in the throat. This includes hot dogs,
  nuts, chunks of meat or cheese, grapes, hard or sticky candy, popcorn, chunks of
  peanut butter, or raw carrots.

• Supervise mealtimes with young children.

• Prevent older siblings from giving a dangerous food or toy to a young child.

What is the advised first aid technique
for choking?

A series of back blows and
under-the-diaphragm abdominal thrusts are advised for adults and children over age
one
year who are choking on a piece of food or a foreign object and are conscious. Choking
is when a person can’t speak, cough, or breathe because something is blocking
(obstructing) the airway. No air can get through. If the airway stays blocked, it
can
lead to a loss of consciousness and death. When applying the abdominal thrusts, be
careful not to use too much force so you don’t damage the ribs or internal organs.
If
the person is unconscious, use chest compressions.

First, perform a series of 5 back blows.

• If you are able, gently lean the person forward so their
  upper body is parallel with the ground. Use one arm across the person’s chest for
  support. If the person is a child, kneel down behind them.
• Use the heel of your free hand to give 5 quick thumps (back
  blows) between the person’s shoulder blades.

Then perform 5 abdominal thrusts.
Abdominal thrusts lift the diaphragm. They force enough air from the lungs to create
an
artificial cough. This cough helps move air through the windpipe, pushing and expelling
the obstruction out of the airway and mouth:

• Reach around the person’s
  waist.

• Position one clenched fist
  above the navel (belly button) and below the rib cage.

• Grasp your fist with your
  other hand. Pull the clenched fist sharply and directly backward and upward under
  the rib cage 5 times quickly.

• If the person is obese or in
  late pregnancy, give chest thrusts.

• Keep doing back blows and
  abdominal thrusts without stopping until the obstruction is relieved, the person
  becomes unconscious, or advanced life support is available. In either case, the
  person should be examined by a healthcare provider as soon as possible. 

If you are by yourself and choking, you can do thrusts on yourself.
Or you can thrust your upper abdomen against the back of a chair or the edge of a
counter.

To minimize possible harm, back blows and abdominal thrusts should only be used in actual emergencies when it is sure that the person is choking. Use this method only in adults and children
over
1 year old.

A different method is used in
infants under 1 year old. Discuss the correct first aid choking method for your child
with their healthcare provider.

How can I learn the right way to help someone who is choking?

Using back blows and abdominal
thrusts is simple to learn. It is often taught during first aid and cardiopulmonary
resuscitation (CPR) classes. Contact your local chapter of the American Red Cross
or
American Heart Association. Or contact your local hospital or healthcare facility
for a
class schedule and more information.

What should I do if someone is choking?

Choking happens when someone’s airway suddenly gets blocked, either fully or partly, so they can’t breathe or breathe properly.

This information applies to adults.

If you want advice for children, see How to stop a child from 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’ll usually be able to clear the blockage themselves.

To help with mild choking in an adult:

• encourage them to keep coughing to try to clear the blockage
• ask them 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

If coughing doesn’t work, start back blows.

Severe choking: back blows and abdominal thrusts

Where choking is severe, the person won’t be able to speak, cry, cough or breathe. Without help, they’ll eventually become unconscious.

To carry out a back blow on an adult:

• Stand behind them and slightly to one side. Support their chest with 1 hand. Lean them forward so the object blocking their airway will come out of their mouth, rather than moving further down.
• Give up to 5 sharp blows between their 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 5 abdominal thrusts.

Abdominal thrusts

Don’t give abdominal thrusts to babies under 1 year old or pregnant women.

To carry out an abdominal thrust:

• Stand behind the person who’s choking.
• Place your arms around their waist and bend them forward.
• Clench 1 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 5 times.

If the person’s airway is still blocked after trying back blows and abdominal thrusts, get help immediately:

• Call 999 and ask for an ambulance. Tell the 999 operator the person is choking.
• Continue with the cycles of 5 back blows and 5 abdominal thrusts until help arrives.

If they lose consciousness and aren’t breathing, you should begin cardiopulmonary resuscitation (CPR) with chest compressions.

Find out how to do compression-only CPR and CPR with rescue breaths

Complications

Get urgent medical help at an A&E, NHS walk-in centre or a GP if:

• they have a persistent cough after choking
• they feel something is still stuck in their throat

Abdominal thrusts can cause serious injuries. A health professional such as your GP or a doctor in A&E should always examine someone after they have received abdominal thrusts.

Further information

• How to stop a child from choking
• First aid
• British Red Cross: Learn first aid for someone who is choking

Page last reviewed: 14 September 2022
Next review due: 14 September 2025

Fear of suffocation during a panic attack.

Fear of lack of air, phobia to suffocate

In order to analyze in more detail such a symptom of a panic attack – lack of air and a state of suffocation, let’s remember what a panic attack is, as such, and what are its main symptoms.

So, as many people know, a panic attack is a sudden attack of anxiety and fear without any objective reasons. The state arises absolutely spontaneously, and also suddenly subsides. The main symptomatology lies mainly in the somatic field. According to statistics, 1 out of 20 people suffer from this psychosomatic disease, and young people and women experience it more often than the elderly and men.

Main symptoms:

As noted above, the symptoms of this psychopathy appear absolutely for no reason, in other words, nothing bad happens in the patient’s life, the attack is not associated with a stressful situation or any real threat. In addition, unlike other similar destructions, the manifestations of a panic attack pass within 10-30 minutes and do not leave any reminders of themselves, as if they never happened. What are the basic sensations of the patient expressed in:

• Vividly manifested anxiety , feeling of danger, fear of death and fear of suffocation, without any objective reasons or reasonable explanations
• Tachycardia and dyspnea
• Persistent anginophobia feeling short of breath and fear of suffocation
• Sensation of a lump in the throat
• Neuralgia , chest compression, body pain
• Disorientation in space, dizziness
• Attack of nausea , pain in the gastrointestinal tract
• Tremor and numbness of limbs
• Increased sweating , flushing
• Vision problems , veil before eyes
• Feeling unreality of the situation (events can be perceived as in a dream)

One of the fundamental signs, as noted above, is anginophobia. We will talk about it in more detail in this article.

What is anginophobia

Anginophobia is a persistent fear of suffocation or the inability to breathe. In earlier interpretations, this term meant only the fear of suffocation against the background of a heart attack. In modern psychiatry, the anamnesis of anginophobia is expanded and includes the fear of suffocation or even choking, in general, to face any causes that can stop breathing. The cause of this phobia can be anything, moreover, that does not exist in real life: other people, poor ecology, unhealthy lifestyle, diseases that may not exist. It’s important to notice. That anginophobia can also occur in people who are healthy from the point of view of somatics.

Signs and causes of anginophobia

General signs of this particular symptom of panic attacks do not differ much from the main list and include such manifestations as:

• Vertigo disease (vertigo) and spatial disorientation
• Feeling sick
• Tachycardia
• Increased sweating
• Gastrointestinal disorder
• Trembling and numbness of limbs
• Numbness, fear of losing speech or inability to say anything
• Discoloration of the skin on the face or body
• Coughing fit and general feeling of being unable to breathe
• Loss of contact with reality , feeling faint

Causes of anginophobia:

It is worth noting that, according to the psychiatric community, anginophobia often comes in combination with such types of neurosis and neurasthenic disorders as anxiety, schizoid, bipolar and cardiophobic (fear of cardiac arrest).

Common causes include:

• Hazardous working conditions and professions involving a real risk to life, a modified environment and confined spaces. Work in mines, at depth, at height (high-rise workers, submariners, miners, firefighters). A subconscious sense of danger can lead to similar neurotic changes.
• Wrong way of life and addictions: Alcoholism, drug addiction, substance abuse and even smoking. As well as deliberate provocation of the state of asphyxia, for example, a tendency to suffocate during intimate games.
• Presence of bronchial asthma or allergies . Subconsciously, the patient is afraid that in the end he will not be able to breathe during the next attack.
• Increased suggestibility and information rubbish. Some people attach too much importance to stories and what the media broadcasts.
• Past psychotrauma associated with suffocation. Such a stressful situation can subsequently accompany a person all his life and manifest itself when, in fact, there is no real threat.
• Real serious diseases related to the respiratory or cardiovascular system. Fear of attacks of the past.

How to overcome the fear of suffocation

With a mild course of the disease and moderate symptoms of an attack, a person is able to calm himself and reduce the symptoms to nothing in the shortest possible time.

It is in relation to panic attacks and any of their manifestations that the phrase “saving the drowning is the work of the drowning themselves” comes in very handy. In a situation of an attack, it is extremely important for a person to remember that breathing is a natural process, and by itself it cannot be interrupted. Even the presence of serious pathological changes, such as asthma, for example, cannot lead to suffocation if you monitor your condition and control the course of the disease. In order to minimize possible attacks, it is very important to treat yourself and your body with care and attention, lead a proper lifestyle, control your physical, and above all, your mental state. Quite often, people are able to anticipate the onset of an attack and calm themselves down on their own or take a number of actions that can help.

What to do during a panic attack. How to quickly relieve a symptom

In the event of an attack, it is important:

• Move away from the edge of the road and from the main streams of people, ideally find a calm, least crowded place.
• If medication is prescribed, take medication as soon as possible.
• Independently shift the focus of attention from internal to external sensations, you can simply start counting up to 100 or look around and name the colors of the surrounding objects.
• Concentrate on sounds and sensations, say out loud what you see, feel or hear.
• Try to find tension in the body and relax.
• Decentralize attention, for example, play a game on the phone

What to do if during a panic attack you suffer from suffocation and lack of air:

• Work with breathing and try to stabilize it yourself. For 4 seconds a slow breath and for 4 seconds the same exhalation.
• Optional bag breathing method to neutralize lung hyperventilation and carbon dioxide concentration.
• Try to exhale as much as possible. Exhalation should be easy, which means that the feeling of the impossibility of inhalation is nothing more than a consequence of neurosis.

If a panic attack overtook a person next to you, the main task is to take him to a quiet deserted place and help stabilize his breathing.

As we already know, one of the most frightening signs for the patient is a feeling of lack of air. Most often, our patients describe this symptom as a state of complete destabilization of breathing.

Difficulty breathing during panic attacks

Shortness of breath is one of the most common and frightening symptoms. In a state of suffocation, it is important for the patient to remember that everything that happens and even real sensations in the body are a consequence of his neurotic state at the moment. The most dangerous moment is the possibility of a real attack of asphyxia associated with a physical condition, but even here there is a way to calm yourself. Take, for example, a disease such as asthma, which can actually be a symptom of suffocation. So, in this aspect, it is important to know that in a state of neurosis, a person, first of all, cannot inhale, although he does not feel any problems with exhalation, and there may also be a “lump in the throat.” So, with asthma, everything happens the other way around: inhalation is easy, but the asthmatic can no longer exhale or does it with great difficulty.

Is it possible to suffocate from a panic attack

No. If asthma attacks are associated specifically with a panic attack, then this is not dangerous to health. All symptoms disappear as soon as the patient manages to calm down.

Lack of air and the inability to breathe evenly affect the mental state, anginophobia and unregulated fear can prolong the attack and eventually lead to a more severe stage and chronic pathology, for example, develop a generalized disorder, the duration of an attack in which can reach up to 1 hour.

That is why it is extremely important to monitor your condition and try to prevent the development of the chronic form of various disorders.

What can I do to prevent a panic attack from turning into a panic disorder?

First of all. It is necessary to follow the rules of prevention, which we have already talked about in this article: control of one’s own condition, the right lifestyle, accompanying body-oriented practices (meditation, yoga, massages, hydrotherapy), correct thinking and avoiding an overabundance of information. However, if the choking attack provoked by a panic attack has happened more than once, then you should immediately contact a specialist. Professional timely treatment can not only prevent the development of various disorders, but also completely nullify the symptoms.

How to treat panic attacks and when to see a specialist

In fact, it is necessary to see a specialist even if you are experiencing an attack for the first time. There can be a huge number of reasons for a panic attack, which can only be determined by resorting to professional diagnostics. Timely initiation of treatment can save a person from many further problems. It is also worth paying attention to the symptoms. If asthma attacks, accompanied by a feeling of inability to inhale, occur more than 1 time, then this is the sign in which you should immediately contact specialists: a psychotherapist, a neurologist and a psychiatrist. A psychologist will not help in this case, since he works exclusively in the mental field. A panic attack is a psychosomatic disease that affects not only the mental, but primarily the physical plane. Psychotherapeutic treatment includes an integrated approach consisting of medication and psychotherapy.

Definitely will be in the development of a treatment plan. The initial causes that led to the development of panic states, as well as concomitant diseases and individual characteristics of the patient’s psyche, were taken into account.

Psychotherapeutic approach

Most often, the most popular method in psychotherapy is the method of CBT (cognitive – behavioral therapy), the main purpose of which is to correct the patient’s behavior during an attack and change his perception of what is happening. In other words, this technique can be called fear management lessons. Next, classical psychoanalysis is applied, aimed at finding the underlying causes and possible psychotraumas that led to the current state. Also mandatory will be body-oriented practices that help to relax and learn to be aware of the processes occurring in the body. Quite often, psychotherapy also includes gestalt therapy, which can identify unmet needs and family sessions, in which the specialist works with the patient’s relatives in order to teach them first aid and general support.

Drug therapy

A well-chosen course of drugs helps to reduce the frequency and intensity of panic attacks. Most often in modern drug psychotherapy, drugs of the following clusters are used:

• Tranquilizer Cluster . It is used for immediate relief of an attack. It is advised to use with caution and only in a situation of urgent need, since this group has a number of side effects: decreased attention, deconcentration.
• Cluster of antidepressants . The use of course therapy is allowed. Aimed at improving mood, relieving anxiety and relieving symptoms of depression.
• Cluster of beta-blockers . Aimed at stopping seizures with pronounced somatics: increased blood pressure, tachycardia, shortness of breath.
• Nootropic Cluster . It has an anti-stress effect, activates the brain and increases the effectiveness of other medicinal groups.

Cluster of nootropics. It has an anti-stress effect, activates the brain and increases the effectiveness of other medicinal groups.

Ascariasis – symptoms, causes, signs and methods of treatment in adults in the “SM-Clinic”

This disease is treated by Gastroenterologist
, Infectionist

• About the disease
• Species
• Signs and symptoms of ascariasis in humans
• Causes of ascariasis
• Methods for diagnosing ascariasis
• Expert opinion
• Treatment of ascariasis
• Prevention of infection with ascariasis
• Rehabilitation
• Questions and Answers
• Doctors

About the disease

Ascariasis is considered one of the most common infestations that is transmitted through the soil. According to experts from the World Health Organization, more than 1 billion people worldwide suffer from this pathology. Especially often the spread of ascariasis is observed in children and adolescents.

The immediate cause of ascariasis is the ingestion of an invasive egg by a human. The egg contains a mature larva. The main route of transmission is contact-household. The larva leaves the shell in the intestinal lumen and enters the venous bed, and then penetrates into the lungs. Through the bronchial tree, it crawls out into the pharynx and is re-swallowed with saliva into the intestines. After 2–3 months in the intestine, it transforms into an adult. Migration of the larva is usually accompanied by coughing and inflammation of the bronchial wall.

Clinical manifestations of helminthiases are often non-specific and may have different masks of infectious and non-infectious diseases. This creates certain diagnostic difficulties and can complicate the course of existing diseases. In some cases, ascariasis can become the main cause of the development of somatic, to a greater extent, allergic pathology, including bronchial obstruction syndrome. Sometimes ascariasis is complicated by obstruction of the digestive system, which may be an indication for urgent surgical intervention.

Diagnosis of the disease is carried out on the basis of microscopic examination of feces, in which helminths can be detected. However, a negative result of the coprogram does not exclude helminthic invasion. Therefore, to establish an accurate diagnosis, a comprehensive laboratory study is carried out, which includes the determination of antibodies to roundworms, a general clinical and biochemical blood test.

Treatment of ascariasis (uncomplicated forms) consists of anthelmintic therapy. In case of intestinal obstruction, emergency surgical intervention is performed.

Species

There are 2 stages during ascariasis:

• Migratory (pulmonary).
• Enteric.

There are 2 forms of ascariasis:

• uncomplicated;
• complicated.

The disease can be acute or chronic.

Signs and symptoms of ascariasis in humans

As a rule, the disease in the migratory stage is asymptomatic, but sometimes there may be malaise, cough and nausea. Helminths are powerful antigens for the human body, so allergic skin reactions often develop (most often like urticaria). In the intestinal stage, when the endoparasite is localized in the intestine, the previous signs of ascariasis (weakness, nausea) intensify and new ones appear – headaches and abdominal pains, salivation, activity and appetite decrease. In addition, obstructive complications may develop in the second stage. For example, a ball of helminths in the intestinal lumen can lead to its obstruction. Internal bleeding is also possible, due to the fact that adult helminths attach to the intestinal mucosa with pointed ends. Ingestion of worms into the respiratory tract can cause suffocation (asphyxia).

Causes of ascariasis

The causative agent of ascariasis is round worms of different sexes. As adults, they live in the small intestine. The female is 15-20 cm longer than the male (the length of the female is about 40 cm). The body of the helminth is elongated, spindle-shaped, at the ends there are constrictions that can drill through the mucosal layer. Females differ from males not only in length, but also in the shape of the end part (in males it is bent to the abdomen, and in females it is straight). At the head end there is a mouth opening surrounded by three lips, on which taste buds are located. There are no fixation organs in the helminth, so they constantly move towards the incoming food. In turn, the pointed ends allow you to rest against the walls of the intestine and thereby prevent the exit to the outside with feces.

The source of human invasion is soil contaminated with roundworm eggs. The method of infection is fecal-oral. Invasion usually occurs when a person does not wash their hands, consumes contaminated plant products, or drinks raw water from open water.

Infection usually occurs if a person does not follow the rules of personal hygiene – dirty hands, the use of unwashed vegetables, berries, fruits and raw water from open sources.

Roundworm is characterized by a complex life cycle, which determines its danger to humans. Thus, the larvae formed in the female genital tract are oxygen-dependent. Therefore, with the faeces of the main host, they enter the environment and enter the soil and groundwater. After the egg enters the human intestine (through dirty hands, unwashed vegetables and fruits, contaminated water), the larva is released from the shell and enters the intestinal lumen. She perforates the intestinal wall, enters the bloodstream and then migrates to the lungs located near the heart, where she receives oxygen that is important for her. After about 2 weeks, the larva enters the larynx and causes a reflex cough that facilitates its re-swallowing. Once again in the small intestine, it is transformed into a sexually mature individual. The whole process of morphogenesis takes about 3 months. After the “growing up” of the helminth, the release of eggs into the intestinal lumen begins. Helminth lives for about 12 months.

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If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.

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Methods for diagnosing ascariasis

Based on the clinical symptoms, a qualified physician establishes a preliminary diagnosis of helminthiasis. It is even more confirmed if eosinophilia is detected in the general clinical analysis of the blood. However, normal eosinophil levels do not rule out the presence of helminthiasis.

Subsequent laboratory diagnostics is aimed at identifying the species of the pathogen. The first step is a microscopic examination of feces, in which parasite eggs or especially mature ones can be detected. But it should be borne in mind that the results of this analysis will be negative during the period of migration of ascaris larvae, with a low degree of invasion, and also if only males are present in the patient’s intestines. In this regard, additional methods for diagnosing ascariasis are serological studies aimed at identifying specific immunoglobulins M and G in the patient’s blood serum. For a functional assessment of the state of the digestive tract, a biochemical blood test is performed.

Expert opinion

In most cases, ascariasis is latent, without specific symptoms, and often the diagnosis is made “accidentally” during medical examinations. Considering that potential transmission factors constantly surround a person, it is recommended to undergo a screening examination. This allows you to timely establish the correct diagnosis and prescribe treatment, thereby avoiding the development of dangerous complications. Preventive examination is also recommended at the stage of conception planning, because. if helminthiasis is detected during pregnancy, then the possibilities of antihelminthic treatment are significantly limited.

Martishevskaya Evgenia Anatolyevna

Pediatrician, infectious disease specialist, PhD

Treatment of ascariasis

According to the clinical guidelines for ascariasis, uncomplicated forms are treated conservatively. With the development of complications, surgery may be the only correct solution.

Conservative treatment

If roundworm eggs or mature helminths are found in the feces, antihelminthic chemotherapy is performed. The standard course of treatment lasts about 3 days. Roundworms are highly sensitive to the right treatment, so the recurrence of the disease is associated only with re-infection. As part of complex therapy, desensitizing drugs and agents that improve digestion can also be prescribed.

Surgical treatment

With the development of acute surgical pathology, surgical treatment of complications of ascariasis is indicated. The operation consists in removing the helminth tangle and restoring the passage through the intestines.

Prevention of infection with ascariasis

Prevention of ascariasis consists in careful observance of sanitary and hygienic rules:

• frequent washing of hands with soap, especially before eating, and also after harvesting;
• refusal to use unwashed crop products;
• food protection against insects (cockroaches, flies, ants and others).

In the villages, as part of the prevention of infection with ascariasis, it is important to stop using human feces as fertilizer for the garden. This poses a potential danger to the public.

Rehabilitation

After surgery, early activation, adherence to a sparing diet, and time limitation of strength training are shown.

Possible complications

• Intestinal obstruction is one of the most common variants of complicated ascariasis, which develops as a result of obstruction of the intestinal lumen by helminths. Symptoms of ascariasis in humans with the development of acute intestinal obstruction are characterized by intense abdominal pain, stool and gas retention, flatulence, vomiting with or without nausea. The higher the level of mechanical obstruction, the earlier the gag reflex appears and the more pronounced it is. Abdominal pain is usually spasmodic. On palpation, tumor-like densely elastic conglomerates, which are painful, can be detected.
• Peritonitis. Its development may be due to the fact that adult roundworms are able to enter the abdominal cavity, perforating the intestinal wall.
• Allergic reactions. With toxic sensitization by foreign proteins, which are the decay product of the larvae themselves and their metabolic products, the body is sensitized. This is manifested by all kinds of allergic reactions – from skin rashes to the development of systemic anaphylactoid reactions.
• Ascariasis appendicitis. Cases of inflammation of the vermiform appendix against the background of ascaris invasion are described.

Questions and answers

Diagnosis and treatment of this disease is carried out by an infectious disease specialist.

Ascariasis is not transmitted from person to person, so sick people are not dangerous and do not require isolation.

There is no such vaccine, therefore, preventive treatment of the population is carried out in endemic areas (it helps to reduce the risks of the spread of invasion).

Davydova I.V. Helminthiases registered on the territory of the Russian Federation: epidemiological situation, biology of parasites, pathogenesis, clinic, diagnostics, etiotropic therapy. Consillium Medicum. 2017; 19(8): 32-40.

Parasitoses in children / Arakelyan R.S., Okunskaya E.I., Galimzyanov Kh.M., Bogdanyants M.V., Kimirilova O.G. etc. // Textbook for students. – Astrakhan, 2017. – 46 p.

Safety of food products according to parasitological indicators / S.A. Shemetova, R.S. Arakelyan, N.V. Polyanskaya and others // Bulletin of Avicenna. 2021. V. 23. No. 2. S. 166 – 173.

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