What should you do if someone is choking? How can you prevent choking emergencies? Explore the expert-recommended techniques for managing choking situations and minimizing the risk.

Understanding Choking Emergencies

Choking occurs when food or another foreign object becomes stuck in the airway, preventing oxygen from reaching the lungs and the brain. Lack of oxygen to the brain for more than 4 minutes can lead to brain damage or even death. It’s crucial for everyone to recognize the signs of choking and know how to respond effectively, both at home and in public.

Preventing Choking Emergencies

Choking can be preventable with the right safety measures. For adults, experts recommend:

• Cutting food into small pieces
• Chewing food slowly and thoroughly, especially if wearing dentures
• Avoiding talking and laughing while chewing and swallowing
• Limiting alcohol consumption before and during meals

For children, the prevention strategies include:

• Keeping small objects, such as marbles, beads, and coins, out of reach, especially for children younger than 4 years old
• Preventing children from walking, running, or playing while they have food or toys in their mouths
• Avoiding giving children under age 4 foods that can easily get lodged in the throat, such as hot dogs, nuts, grapes, and raw carrots
• Supervising mealtimes with young children
• Ensuring older siblings do not give dangerous foods or toys to younger children

First Aid for Choking Emergencies

If someone is choking and cannot speak, cough, or breathe, it’s a medical emergency. The recommended first aid technique for adults and children over the age of 1 year involves a series of back blows and abdominal thrusts:

1. Perform 5 back blows: Gently lean the person forward and use the heel of your hand to give 5 quick thumps between their shoulder blades.
2. Perform 5 abdominal thrusts: Reach around the person’s waist, position one clenched fist above their navel, and grasp your fist with your other hand. Pull the clenched fist sharply and directly backward and upward under the rib cage 5 times quickly.
3. Repeat the back blows and abdominal thrusts until the obstruction is relieved, the person becomes unconscious, or advanced life support is available.
4. If the person is obese or in late pregnancy, perform chest thrusts instead of abdominal thrusts.
5. If you are alone and choking, you can do the thrusts on yourself or against the back of a chair or the edge of a counter.

It’s important to note that back blows and abdominal thrusts should only be used in actual choking emergencies, and a different method is used for infants under 1 year old. Consult with a healthcare provider for the appropriate first aid technique for your child.

Learning the Proper Choking First Aid Techniques

Learning the correct way to help someone who is choking is essential. The back blows and abdominal thrusts technique 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 your local hospital or healthcare facility, to find a class schedule and get more information.

Responding to Mild Choking

If the airway is only partly blocked, the person will usually be able to speak, cough, or breathe. In this case, encourage them to cough and do not perform back blows or abdominal thrusts, as this could dislodge the object and cause it to become stuck further down the airway.

Seeking Medical Attention

If the choking person becomes unconscious or the back blows and abdominal thrusts do not resolve the obstruction, call emergency services immediately and begin CPR if the person is unresponsive. Even if the choking incident is resolved, the person should be examined by a healthcare provider as soon as possible to ensure there are no complications.

Conclusion

Choking emergencies require prompt and effective action to save lives. By understanding the prevention strategies and mastering the appropriate first aid techniques, you can be prepared to respond quickly and confidently in a choking situation. Remember, the knowledge and skills gained from first aid and CPR training can make all the difference in an emergency.

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. Acute heart failure (OSN) is a severe pathological condition that develops in patients with various heart diseases and hypertension. disease. This is one of the most common reasons for calling an ambulance and hospitalization of patients, as well as the mortality of the population of our country and the whole world.

The main manifestations (symptoms) of acute heart failure are:

• severe, frequent (more than 24 per minute) noisy breathing – shortness of breath, sometimes reaching the degree of suffocation, with predominant difficulty in breathing and a clear increase in shortness of breath and cough in a horizontal position. A sitting position or a lying position with a high headboard facilitates the patient’s condition;
• often when breathing becomes audible wet squelching rales/sounds interrupted by coughing; in the terminal stage, breathing takes on the character of bubbling with the appearance of foam at the patient’s mouth;
• typical sitting posture of the patient, resting with straight arms on the knees or in the seat (to facilitate breathing)

Acute heart failure can develop very quickly and lead to the death of the patient within 30-60 minutes. In most cases, it takes 6-12 hours or more from the first clinical signs to severe manifestations of AHF, but without medical assistance, the vast majority of patients with AHF die.

Emergency Algorithm for Acute Heart Failure (Advice to the Patient) – Patient Reminder

If patients with hypertension or heart disease (but not lungs or bronchi) develop the above symptoms of AHF, it is necessary to:

• call an ambulance • give the patient a sitting position, preferably in a chair with to lean and involve the intercostal muscles in the act of breathing
• to ensure physical and psycho-emotional peace and fresh air, by airing the room
• lower the legs into a large container (basin, tank, bucket, etc.) with hot water
• in extremely severe cases, tourniquets are applied to the legs in the groin area, compressing the superficial veins, but not deep arteries, which reduces blood flow to the heart and thereby facilitates its work

If the patient or first aid provider has experience for the use of nitroglycerin, it is prescribed at a dose of 0.4 (0.5) mg (inhalation into the oral cavity is performed under the root of the tongue, the tablet / capsule is placed under the tongue, the capsule must first be cracked, not swallowed). When the patient’s well-being improves after the use of nitroglycerin, it is used repeatedly, every 10-15 minutes until the arrival of the ambulance team. In the absence of improvement in the patient’s well-being after the next intake of nitroglycerin, it is no longer used.

Attention! A patient with AHF must exclude all physical activity, it is strictly forbidden to walk, smoke, drink water and take liquid food until the special permission of the doctor; you can not take nitroglycerin with blood pressure less than 100 mm Hg. with severe headache, dizziness, acute impairment of vision, speech or coordination of movements.

All patients with hypertension or heart disease with shortness of breath and edema in the legs should discuss with their doctor which drugs should be taken in the development of AHF, clearly write down their names, dosage and time sequence (algorithm) of their administration, and check with the doctor under what manifestations of the disease it is necessary to urgently call an ambulance.