Medical Treatment

Treatment begins when local emergency medical services (EMS) arrive on the scene. They have several ways to treat a choking person. In addition to being skilled in the choking treatment and CPR, they also may have several tools to assist them in clearing the airway.

• Intubation: a breathing tube is passed into a person's windpipe (trachea). This may push the object that is obstructing the airway out of the way enough to provide air to the lungs.

• To perform intubation, a metal scope is inserted into the back of the throat to aid in seeing the vocal cords, which mark the opening of the trachea.
  
  
• If, while using this scope, the object causing the obstruction can be seen, it may then be removed with a long instrument called a Magill forceps.

• If attempts to intubate a person with a complete airway obstruction are unsuccessful, EMS personnel may have to perform a surgical procedure called a cricothyrotomy. This involves cutting the neck and making a hole in the trachea just below the Adam's apple, through which a breathing tube is inserted. This tube should enter the trachea below the spot that is blocked by the foreign body.

• Once at the hospital, a doctor may use a bronchoscope to remove the object. Bronchoscopy involves inserting a flexible fiberoptic scope into the airway (trachea). If something is found, this scope also has attachments that the doctor can use to remove the object.

• To perform this procedure, the person is heavily sedated and the nose numbed with a topical gel. The flexible scope is placed through the nose into the back of the throat and then guided into the trachea.
  
  
• Most people do not remember this procedure being done. It can be performed quickly if a person is in distress, and sedation is always used.

• If all of these maneuvers fail, the choking person will be taken to the operating room to have the foreign body removed and a clear airway established surgically.