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Choking (cont.)

What do emergency personnel do to treat choking?

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.

Choking Follow-up

Follow-up care is rarely needed if the object blocking the airway is removed quickly. Choking victims who require surgery or who suffer brain damage from lack of oxygen will require more extensive follow-up care.

How do I prevent choking?

Be prepared to help: If you are ever in this situation as an observer you will want to be trained in the simple, yet life-saving choking treatment methods and CPR.

Attend a training class: Many are available through the American Heart Association, the American Red Cross, hospitals, worksites, and other local organizations.

Prevention tips for children

  • Don't give young children hard foods or small objects that are likely to become lodged in their airways. This includes nuts, seeds, gum, hard candy, peas, and tough meats. It is recommended that foods such as these not be given to any child younger than four years of age.
  • Cut foods such as hot dogs, sausages, and grapes into small pieces before serving them to young children.
  • Look over toys to find small pieces (eyes and noses on stuffed animals, for example) that the child might be tempted to place in his or her mouth.
  • Choking on a rubber balloon is the leading cause of choking death in children who choke on objects other than food. Clean up right after parties. Toddlers are prone to stick anything they find on the floor into their mouths, including dangerous objects.
  • Store small objects, such as buttons and batteries, out of a child's reach.
  • Do not allow children to play sports with food or gum in their mouths.
  • Tell babysitters and older brothers and sisters what foods and objects should not be given to young children.
  • Instruct children to chew their food thoroughly before swallowing.

Prevention tips for adults

  • Avoid placing objects such as nails or pins in your mouth for quick access.
  • Take small bites and chew food thoroughly.
  • Be aware that alcohol may impair your ability to chew and swallow, and increase your risk of choking.

Choking Prognosis

The lack of oxygen caused by choking can result in brain damage or death in four to six minutes. Unless immediate action is taken to open a completely obstructed airway, the chances for survival and complete recovery decrease rapidly. If the object can be removed quickly and breathing returns to normal, recovery should be complete.

Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine

REFERENCE: Centers for Disease Control. Choking Episodes Among Children.

Medically Reviewed by a Doctor on 10/14/2016

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