Choking Health Dictionary

Asphyxia means literally absence of pulse, but is the name given to the whole series of symptoms which follow stoppage of breathing and of the heart’s action. Drowning is one cause, but obstruction of the AIR PASSAGES may occur as the result of a foreign body or in some diseases, such as CROUP, DIPHTHERIA, swelling of the throat due to wounds or in?ammation, ASTHMA (to a partial extent), tumours in the chest (causing slow asphyxia), and the external conditions of su?ocation and strangling. Placing the head in a plastic bag results in asphyxia, and poisonous gases also cause asphyxia: for example, CARBON MONOXIDE (CO) gas, which may be given o? by a stove or charcoal brazier in a badly ventilated room, can kill people during sleep. Several gases, such as sulphurous acid (from burning sulphur), ammonia, and chlorine (from bleaching-powder), cause involuntary closure of the entrance to the larynx, and thus prevent breathing. Other gases, such as nitrous oxide (or laughing-gas), chloroform, and ether, in poisonous quantity, stop the breathing by paralysing the respiration centre in the brain.

Symptoms In most cases, death from asphyxia is due to insu?ciency of oxygen supplied to the blood. The ?rst signs are rapid pulse and gasping for breath. Next comes a rise in the blood pressure, causing throbbing in the head, with lividity or blueness of the skin, due to failure of aeration of the blood, followed by still greater struggles for breath and by general CONVULSIONS. The heart becomes overdistended and gradually weaker, a paralytic stage sets in, and all struggling and breathing slowly cease. When asphyxia is due to charcoal fumes, coal-gas, and other narcotic in?uences, there is no convulsive stage, and death ensues gently and may occur in the course of sleep.

Treatment So long as the heart continues to beat, recovery may be looked for with prompt treatment. The one essential of treatment is to get the impure blood aerated by arti?cial respiration. Besides this, the feeble circulation can be helped by various methods. (See APPENDIX 1: BASIC FIRST AID – Choking; Cardiac/respiratory arrest.)... asphyxia

See ASPHYXIA; CHOKING.... suffocation

In 2000, more than 12,000 people died in or as a result of accidents in the UK, nearly half occurring at home and around a third in motor vehicle incidents. Many of these deaths would have been preventable, had appropriate safety measures been taken. A high proportion of deaths from accidents occur in males between ?ve and 34 years of age; alcohol is a signi?cant factor. Since the introduction of compulsory use of car seatbelts in the UK in the 1980s, the incidence of deaths from driving has fallen. With employers more aware of the risks of injury and death in the work place – with legislation reinforcing education – the number of such incidents has fallen over the past 50 years or more: this group now accounts for less than 2 per cent of all accidental deaths. Accidental deaths in the elderly are mainly caused by falls, mostly at home. In infants, choking is a signi?cant cause of accidental death, with food and small objects presenting the main hazards. Poisoning (often from drug overdose) and drowning are notable causes between the mid-20s and mid-40s.

See www.rospa.com... accidental death

Rapidly alternating contractions and relaxations of the muscles, causing irregular movements of the limbs or body generally, usually accompanied by unconsciousness.

Causes The most common reason for convulsions is EPILEPSY, and the underlying cause of the latter often remains uncertain. In newborns, convulsions may be due to HYPOXIA following a di?cult labour, or to low levels of sugar or calcium in the blood (HYPOGLYCAEMIA; HYPOCALCAEMIA). A sudden rise of body temperature during infective illness may induce convulsions in an infant or young child.

Diseases of the brain, such as meningitis, encephalitis and tumours, or any disturbance of the brain due to bleeding, blockage of a blood vessel, or irritation of the brain by a fracture of the skull, may also be responsible for convulsions (see BRAIN, DISEASES OF).

Asphyxia, for example from choking, may also bring on convulsions.

Treatment Newborns with hypoglycaemia or hypocalcaemia are treated by replacing the missing compound. Infants with febrile convulsions may be sponged with tepid water and fever reduced with paracetamol.

In epilepsy, unless it is particularly severe, the movements seldom need to be restrained. If convulsions persist beyond a few minutes it may be necessary to give BENZODIAZEPINES, either intravenously or rectally. In the UK, paramedics are trained to do this; likewise many parents of epileptic children are capable of administering the necessary treatment. If however this fails to stop the convulsions immediately, hospital admission is needed for further treatment. Once ?ts are under control, the cause of the convulsions must be sought and the necessary long-term treatment given.... convulsions

Deglutition means the act of swallowing. (See CHOKING.)... deglutition

A term applied generally to any structures of ball shape, but especially to the sensation of a ball in the throat causing choking, which forms a common symptom of acute anxiety (globus hystericus).... globus

The narrow opening at the upper end of the LARYNX. The glottis is made up of the true vocal cords. (See AIR PASSAGES; CHOKING.)... glottis

Sensation of a ‘lump in the throat’ causing a choking under stress of emotion. Related to hysteria with spasm of the pharynx.

Indicated: German Chamomile, St John’s Wort, Balm, Valerian or Lobelia. In the form of tincture, tea, liquid extract or tablets. ... globus hystericus

A first-aid treatment for choking, in which sharp upward pressure is applied to the upper abdomen to dislodge a foreign body obstructing the airway. The technique is also known as the Heimlich manoeuvre.... abdominal thrust

Narrowing or blockage of the respiratory passages. The obstruction may be due to a foreign body, such as a piece of food, that becomes lodged in part of the upper airway and may result in choking. Certain disorders, such as diphtheria and lung cancer, can cause obstruction. Additionally, spasm of the muscular walls of the airway, as occurs in bronchospasm (a feature of asthma), results in breathing difficulty.... airway obstruction

Oesophagitis is in?ammation of the OESOPHAGUS and may be due to swallowing a corrosive chemical (corrosive oesophagitis) or because the muscles of the lower part of the oesophagus do not work properly (ACHALASIA), allowing the stomach’s acidic contents to regurgitate (re?ux oesophagitis). HIATUS HERNIA is sometimes associated with the latter condition. Diagnosis can be made by ENDOSCOPY of the oesophagus and/or an X-ray examination using a barium swallow. Treatment of re?ux oesophagitis is by an appropriate diet and weight loss. Stricture of the oesophagus can result from swallowing a corrosive ?uid and may produce severe narrowing. Such strictures may sometimes be dilated by the use of suitable instruments; otherwise, surgery may be necessary.

A still more serious and frequent cause of oesophageal stricture is that due to cancer, which may occur at any part, but is most common at the lower end, near the entrance into the stomach. The chief symptoms of this condition are increasing di?culty in swallowing, increasing debility, together with enlargement of the glands in the neck. The condition usually occurs in middle age or beyond and around 5,000 people are diagnosed with such cancer every year in the United Kingdom. In many cases treatment can only be palliative, but recent advances in surgery are producing promising results. In some cases treatment with irradiation or anti-cancer drugs produces relief, if not cure. In those in whom neither operation nor radiation can be performed, life may be prolonged and freedom from pain obtained by ?uid food which is either swallowed or passed down a tube. In cases of achalasia (see above), the passage of a special bougie down the oesophagus to dilate the sphincter may be e?ective.

Strictures of the oesophagus may also be produced by the pressure of tumours or aneurysms within the cavity of the chest but external to the gullet.

Finally, di?culty in swallowing sometimes occurs in certain serious nervous diseases from paralysis affecting the nerves supplying the muscular coats of the PHARYNX, which thus loses its propulsive power (bulbar paralysis).

Foreign bodies which lodge in the respiratory part of the throat – i.e. at the entrance to, or in the cavity of, the larynx – set up immediate symptoms of CHOKING. Those which lodge in the gullet, on the contrary, do not usually set up any immediately serious symptoms, although their presence causes considerable discomfort. Medical attention is usually required.... oesophagus, diseases of

Defects and disorders of the brain, which may have one of numerous causes including infection, injury, brain tumour, or a lack of blood or oxygen (hypoxia). Because the brain is encased in the skull, any space-occupying tumour, brain abscess, or haematoma creates raised pressure, which impairs the function of the whole brain. Brain disorders that are localized in a small region may affect a specific function such as speech (see aphasia). More often, damage is more diffuse and the symptoms can be varied and numerous. Some brain disorders are congenital due to genetic or chromosomal disorders, as in Down’s syndrome. Structural defects that arise during the development of the fetus in the womb include hydrocephalus and anencephaly.

Reduced oxygen supply may occur at birth, causing cerebral palsy. Later in life, cerebral hypoxia can result from choking or from arrest of breathing and heartbeat. From middle age onwards, cerebrovascular disease is the most important cause of brain disorder. If an artery within the brain becomes blocked or ruptures, leading to haemorrhage, the result is a stroke. The brain may also be damaged by a blow to the head see head injury).

Infection within the brain (encephalitis) may be due to viral infection. Infection of the membranes surrounding the brain (meningitis) is generally due to bacterial infection. Creutzfeldt–Jakob disease is a rare, fatal brain disease associated with an infective agent called a prion which, in some cases, has been linked with (bovine spongiform encephalopathy), a disease in cattle.

Multiple sclerosis is a progressive disease of the brain and spinal cord. Degenerative brain diseases include Alzheimer’s disease and Parkinson’s disease. Emotional or behavioural disorders are generally described as psychiatric illnesses; but the distinction between neurological and psychiatric disorders is now much less clear.... brain, disorders of

A first aid technique to unblock the airway in cases of choking. when abdominal thrusts would be dangerous (such as in infants) or impossible (such as in pregnant women). In a chest thrust, the first-aider places a fist in the other hand, and, pressing against the victim’s lower breastbone, thrusts the chest wall inwards up to 5 times. The pressure simulates the coughing reflex and may expel the obstruction.

chest X-ray One of the most frequently performed medical tests, usually carried out to examine the heart or lungs to confirm diagnoses of heart disorders and lung diseases. (See also X-rays.)... chest thrust

An object that is present in an organ or passage of the body but which should not be there. Common sites for foreign bodies include the airways (see choking), ear (see ear, foreign body in), eye (see eye, foreign body in), rectum, and vagina.... foreign body

A first-aid treatment for choking. The sole aim of the Heimlich manoeuvre is to dislodge the material that is causing the blockage by placing one fist, covered by the other, just below the victim’s rib cage, and pulling sharply inwards and upwards to give an abdominal thrust.... heimlich manoeuvre

The practice of inhaling the intoxicating fumes given off by certain volatile liquids. Glue sniffing is the most common form.

Inhalation of solvent fumes produces a feeling of intoxication similar to that produced by alcohol. Solvent abuse can cause headache, vomiting, confusion, and coma. Death may occur due to a direct toxic effect on the heart, a fall, choking on vomit, or asphyxiation. Longterm effects include erosion of the lining of the nose and throat, and damage to the kidneys, liver, and nervous system.

Acute symptoms resulting from solvent abuse require urgent medical attention. Counselling may be helpful in discouraging the behaviour.... solvent abuse

(Heimlich manoeuvre) a manoeuvre for the treatment of choking in which the patient is held firmly around the midriff just under the ribcage. The hands of the rescuer are held as a fist and short sharp thrusts into the patient’s upper abdomen are made in order to dislodge the obstructing article from the airway. This manoeuvre should not be performed on children under the age of one year.... abdominal thrusts

a manoeuvre for the treatment of a choking patient. Firm slaps are given to the patient’s back in an attempt to dislodge the obstructing article from the upper airway.... back slaps

n. a poisonous gas developed during World War I. It is a choking agent, acting on the lungs to produce *oedema, with consequent respiratory and cardiac failure.... phosgene