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Choking – Causes, Symptoms, Treatment and Prevention

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Choking is actually the blockage of the upper airway by food or any other objects. It prevents proper breathing in a person. Choking leads to usual coughing fit but absolute blockage of the airway can cause death. Choking is a medical emergency which calls for appropriate, fast action for anyone who is available. Emergency medical teams may not be available on time to save the life of a choking person. Breathing is a very important part of life. While inhaling, we breathe in a mixture of carbon dioxide, oxygen, nitrogen and other gasses.

Oxygen enters the bloodstream in the lungs which travel into the rest of the body. Oxygen is used by our body as a fuel to make energy from the food we consume. The waste product, carbon dioxide enters the bloodstream and gets back to the lungs. We breathe out nitrogen, carbon dioxide, and oxygen when we exhale. When something is choking and blocking the airway, oxygen cannot enter the lungs. The brain is very sensitive to the oxygen supply. When it lacks, the brain starts to die within 4 to 6 minutes. The first aid should take place during this time. Within just 10 minutes, it causes irreversible brain death.


Causes of Choking

When a piece of food is stuck in the upper airway, choking occurs. There are two openings in the back of your mouth. One is trachea through which opening air passes to enter into the lungs. Other is esophagus through which food goes down to the stomach. When you swallow something, the trachea is roofed by the flap, which is known as epiglottis. It keeps food from entering the lungs. Trachea splits into the right and left stem, bronchus. It leads to the right and left lungs. They branch into smaller tubes when they spread through the lungs. Any object ending in the airway will get stuck when the airway narrows down. A lot of large objects are stuck within the trachea at the vocal cords.

Choking occurs most often due to improper chewing of food in adults. If you laugh or talk while eating, a piece of food may enter the wrong pipe. It may slow down the normal swallowing system if you are taking drugs or drinking alcohol. Some of the common risk factors in older adults is poor fitting dental work, aging and consumption of alcohol. In children, some of the common causes are improper chewing of food, trying to eat a lot of food, swallowing hard candy, and trying to eat a large bite. Kids also put small objects in the mouth which gets clogged in their throat. For example, coins, pins, or marbles are biggest choking hazards.


In adults, you may find these symptoms –

  • Sudden inability to talk
  • Gagging or coughing
  • Panicking and hand signals like pointing to the throat
  • Wheezing
  • Passing out
  • Clutching the throat – Grabbing the throat with both or one hand is the natural response to this condition. It is the universal sign of choking to tell others that you are choking.
  • Cyanosis – Turning the skin blue can be spotted earliest around the lips, face, and fingernail beds. Some other signs of choking may appear first.
  • In an infant, you have to pay added attention to their behavior. They don’t know the universal signs of choking. This way, you have to watch out for a weak cough, weak cry or both, and problem in breathing


Emergency personnel may provide the life support to the person to help him breathe at the hospital and in the ambulance. Doctor may perform various procedures and tests at the hospital in order to figure out the cause of choking and to ensure that no other objects block the airway.

  • Bronchoscopy – In this procedure, a flexible fiberoptic scope is inserted into the trachea (airway). This way, the doctor can search for the alien bodies in the airway. It also has attachments which can be used by the doctors if something is found, to remove them.


  • X-rays – It is helpful to check out why the airway of the person is partially blocked. All the objects cannot be seen in x-rays. If they are found, they are known as radio-opaque objects. They can easily be spotted on chest or neck. Some of the common objects are nails, tacks, and coins.


When emergency medical services (EMS) arrive, treatment starts on the spot. They can treat the choking person in different ways. Along with being skilled in CPR and choking treatment, they can also help the patients with several tools to clear the airway.


In this process, a breathing tube is inserted into the windpipe of a person. It may push the object blocking the airway, to provide enough air to the lungs.  This way, a metal scope is inserted into the back of the throat in order to help check out the vocal cords and the opening of the trachea is marked. While using this scope, if object causes obstruction is spotted, it will be removed using Magill forceps.

If this attempt is failed, the EMS personnel perform cricothyrotomy, a surgical procedure. In this procedure, the neck is cut to make a hole in the airway with which they insert the breathing tube below the Adam’s apple. The tube is inserted below the spot which is blocked.


If you are stuck in this situation ever as an observer, you need to get trained in life-saving, simple choking treatment method. Most of the training classes are offered through the American Red Cross, American Heart Association, worksites, hospitals, and various local organizations.

Prevention for Kids

Don’t provide hard candies or small objects to young children who can get stuck in the airways, such as seeds, nuts, peas, gums and solid meats. Don’t give these foods to the child below 4 years. Before serving sausages, hot dogs, and grapes, cut them into small pieces. Keep an eye on small pieces on toys like noses and eyes on soft toys, because they might be tempted to put it in their mouth.