{{infobox disease |name | Choking |ICD10 F41.0, R06.8, T17, W78-W80 |ICD9 , |MeshID D000402 | }} |
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Choking can be caused by:
This type of choking is often suffered by small children, who are unable to appreciate the hazard inherent in putting small objects in their mouth. In adults, it mostly occurs whilst the patient is eating. In one study, peanuts were the most common obstruction.
Many members of the public associate abdominal thrusts, also known as the Heimlich Maneuver with the correct procedure for choking, which is partly due to the widespread use of this technique in movies, which in turn was based on the widespread adoption of this technique in the United States at the time.
Most modern protocols (including those of the American Heart Association and the American Red Cross, who changed policy in 2006 from recommending only abdominal thrusts) involve several stages, designed to apply increasingly more pressure.
The key stages in most modern protocols include:
The back slap is designed to use percussion to create pressure behind the blockage, assisting the patient in dislodging the article. In some cases the physical vibration of the action may also be enough to cause movement of the article sufficient to allow clearance of the airway.
Almost all protocols give back slaps as a technique to be used before to the consideration of potentially damaging interventions such as abdominal thrusts, but Henry Heimlich, noted for promulgating abdominal thrusts, wrote in a letter to the New York Times that back slaps were proven to cause death by lodging foreign objects in to the windpipe.
The findings of a 1982 Yale study by Day, DuBois, and Crelin that "persuaded the American Heart Association to stop recommending back blows for dealing with choking...was partially funded by Heimlich's own foundation." According to Roger White MD of the Mayo Clinic and American Heart Association (AHA), "There was never any science here. Heimlich overpowered science all along the way with his slick tactics and intimidation, and everyone, including us at the AHA, caved in."
===Abdominal thrusts===
Abdominal thrusts, also known as the Heimlich Maneuver (after Henry Heimlich, who first described the procedure in a June 1974 informal article entitled "Pop Goes the Cafe Coronary", published in the journal Emergency Medicine). Edward A. Patrick, MD, PhD, an associate of Heimlich, has claimed to be the uncredited co-developer of the procedure. Heimlich has objected to the name "abdominal thrusts" on the grounds that the vagueness of the term "abdomen" could cause the rescuer to exert force at the wrong site.
Performing abdominal thrusts involves a rescuer standing behind a patient and using their hands to exert pressure on the bottom of the diaphragm. This compresses the lungs and exerts pressure on any object lodged in the trachea, hopefully expelling it. This amounts to an artificial cough.
Due to the forceful nature of the procedure, even when done correctly it can injure the person on whom it is performed. Bruising to the abdomen is highly likely and more serious injuries can occur, including fracture of the xiphoid process or ribs.
In some areas, such as Australia, authorities believe that there is not enough scientific evidence to support the use of Abdominal thrusts and their use is not recommended in first aid.
Some protocols advocate the use of the rescuer's finger to 'sweep' foreign objects away once they have reached the mouth. However, many modern protocols recommend against the use of the finger sweep as if the patient is conscious, they will be able to remove the foreign object themselves, or if they are unconscious, the rescuer should simply place them in the recovery position (where the object should fall out due to gravity). There is also a risk of causing further damage (for instance inducing vomiting) by using a finger sweep technique.
Category:Medical emergencies Category:Causes of death Category:First aid Category:Symptoms and signs: Respiratory system
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