Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air.
The Dangers of Choking
Food or small objects can cause choking when they get caught in the throat and block the airway, preventing oxygen from getting to the lungs and the brain. Because of this, when the brain goes without oxygen for more than four minutes, brain damage or even death may occur.
Every child is at risk for choking. Younger children are particularly at risk because of their tendency to place objects in their mouths, poor chewing ability, and narrow airways compared with those of older children and adults.
Children younger than 6 years do not have all their molars, the grinding teeth at the back of the mouth. Food can get to the back of the jaw and without being crushed by the teeth, the food is pushed to the back of the throat and the body instantly swallows it. If it happens quickly, it may not lead to a coordinated swallow. Or if a child laughs or takes a deep breath, the food can be inhaled.
Inhaled food is drawn into the windpipe (trachea) and travels into one of two bronchial tubes (bronchi), where it can block the flow of air into the lungs. Depending on the size and shape of the food particle, it can go further to a point where it actually plugs up one of the smaller branches of a bronchial tube and can cause part of the lung to collapse. Even if the particle does not entirely clog the airway, it has picked up bacteria from the mouth or elsewhere and can cause respiratory infection, such as pneumonia.
Parents and caregivers can take steps to reduce the risk of choking in children.
- Keep a watchful eye on children who are eating and playing
- Keep dangerous toys, foods, and household items out of reach
- Learn how to provide early treatment for children who are choking.
Parents should supervise young children during mealtime, and should teach children to chew their food well. Children should be sitting, not lying down or in motion while eating. Eating on the run increases the risk of choking.
It is recommended that children younger than 4 not be fed any round, firm food unless it is cut into small pieces no larger than one-half inch. Children under 4 do not have a full set of teeth and cannot chew as well as older children, so large chunks of foods may lodge in the throat and cause choking. And caregivers should be aware of older children's actions. Many choking incidents occur when older brothers or sisters give dangerous foods, toys, or small objects to a younger child.
Although food items are the cause of most choking injuries in children, toys and household items can also be hazardous. Balloons, when uninflated or broken, can choke or suffocate young children who try to swallow them.
Medications in the form of pills can present a potential choking risk for small children. Make sure that a child is old enough to comfortably swallow a pill. Parents with children who have trouble swallowing pills should ask their doctor to prescribe a liquid or other form. Some medications come in liquid, syrup, or effervescent form.
By being alert to potential choking hazards, parents can make their environment safer for children. But sometimes, despite all precautions, a child may choke. Parents who know basic choking rescue procedures may be able to save their child's life.
Knowing how to perform CPR procedures on a child or adult who has stopped breathing can also mean the difference between life and death.
Unsafe Foods for Young Children
keep the following foods away from children younger than 4:
Dangerous Objects for Young Children
- hot dogs
- nuts and seeds
- chunks of meat or cheese
- whole grapes
- hard, gooey, or sticky candy
- chunks of peanut butter
- raw vegetables
- chewing gum.
Keep the following items away from infants and young children to reduce the risk of choking:
Actions to Relieve Choking in an Infant
- latex balloons
- toys with small parts
- toys that can be compressed to fit entirely into a child's mouth
- small balls
- pen or marker caps
- small button-type batteries
- medicine syringes.
1. Hold the infant face-down on your forearm. Support the infant's head and jaw with your hand. You may need to sit or kneel and rest your arm on your lap or thigh.
2. Give up to five back blows with the heel of your free hand.
3. If the object comes out and the infant begins to breathe after only a few back blows, stop the back blows.
If the object does not come out after five back blows, turn the infant onto his or her back and give up to five chest thrusts, supporting the head and neck. Hold the infant with one hand and arm. Use two or three fingers of your free hand to push on the breastbone just as you press for chest compressions during CPR. Stop chest thrusts if the object is forced out.
4. Alternate giving five back blows and five chest thrusts until the object comes out or the infant becomes unresponsive.
5. If the choking is not relieved, the infant will become unresponsive. When the infant becomes unresponsive, Start CPR and at the same time call the doctor without making any late.
Actions to Relieve Choking in a Child Age 1 and Older and Adults
1. Ask, "Are you choking?"
2. If the child speaks or is coughing, do nothing. Allow the child to try to cough up whatever is blocking the windpipe.
3. If the child can't speak, cough loudly, or cry, tell the child you are going to help.
4. Stand or kneel firmly behind the child and wrap your arms around the child.
5. Make a fist with one hand.
6. Put the thumb side of the fist on the child's abdomen, slightly above the navel and well below the breastbone.
7. Grasp the fist with your other hand and give quick upward thrusts into the child's abdomen.
8. Give thrusts until the object is forced out or the child becomes unresponsive.
9. If the choking is not relieved, the child will become unresponsive. When the child becomes unresponsive, shout for help, lower the child to the ground, and start CPR. Immediately call the doctor for help.