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Choking, also known as foreign body airway obstruction (FBAO), is a phenomenon that occurs when breathing is impeded by a blockage inside of the respiratory tract. An obstruction that prevents oxygen from entering the lungs results in oxygen deprivation. Although oxygen stored in the blood and lungs can keep a person alive for several minutes after breathing stops, choking often leads to death.
Over 4,000 choking-related deaths occur in the United States every year. Deaths from choking most often occur in the very young (children under 2 years old) and in the elderly (adults over 75 years). Foods that can adapt their shape to that of the pharynx (such as bananas, marshmallows, or gelatinous candies) are more dangerous. Various forms of first aid are used to address and resolve choking.
Choking is the fourth leading cause of unintentional injury death in the United States. Many episodes go unreported because they are brief and resolve without needing medical attention. Of the reported events, 80% occur in people under 15 years of age, and 20% occur in people older than 15 years of age. Choking on a foreign object resulted in 162,000 deaths (2.5 per 100,000) in 2013, compared with 140,000 deaths (2.9 per 100,000) in 1990.
Choking victims may present very subtly, especially in the setting of long term foreign body aspiration. Cough seen in 80% of foreign body aspiration cases, and shortness of breath is seen in 25%. People may be unable to speak, attempt to use hand signals to indicate they are choking, attempt to force vomiting, or clutch at their throat.
Respiratory symptoms can include involuntary cough, gurgling, shortness of breath, labored breathing, or wheezing. Loss of consciousness may occur if breathing is not restored. In the setting of lower airway aspiration, patients may have pneumonia like symptoms such as fever, chest pain, foul smelling sputum, or blood in sputum (hemoptysis). In the case of long term foreign body aspiration, patients may present with signs of lobar pneumonia or pleural effusion.
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