Deaths Associated with Choking in San Diego County
ABSTRACT Death from choking is the fourth most common cause of unintentional-injury mortality, but little data are published on causes or locations of these episodes. These deaths typically are peaked at the extremes of age, with young children and the elderly having the greatest rate of fatal choking. Our objective was to characterize the causes of fatal airway obstruction in adults. The San Diego County Medical Examiner's database was searched for deaths attributed to choking in decedents 18 years and older during the 10-year period from 1994 to 2004. Data were abstracted regarding the underlying medical conditions, items choked on, location of the choking, and treatments involved in the individual cases. We found 133 victims who died from choking, with 14% having using alcohol or other sedatives and 55% having a documented neurological deficit or anatomic difficulty with swallowing. The most common specified food objects that victims choked on were meat products, and 45% occurred at home, followed by 26% at supervised facilities, and 14% at restaurants. Of the 19 choking episodes occurring in restaurants, only one employee was documented to attempt a resuscitative effort. Most victims who choked to death had an underlying neurological deficit, and occurred at home or supervised facilities appear to have an appropriate initial-response intervention.
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ABSTRACT: The retrospective autopsy study included 98 adults who died because of laryngeal choking on a bolus of food: 67 men and 31 women (χ(2)=6.843, p<0.01), average age 58.61±15.87 years (range 26-92 years). Most of the subjects had poor dentition (χ(2) =34.327, p<0.01). Twenty individuals died in medical institutions, and 78 were nonhospitalized individuals. More than a third of the nonhospitalized individuals were under the influence of ethanol at the moment of death: average blood concentration 8.3g/dL (SD=11.0), ranged from 5.0 to 36.0. Nonhospitalized persons were at the moment of event more often under influence of ethanol than the subjects in control group (χ(2)= 38.874, p<0.01), and at the same time significantly more intoxicated (z=-7.126, p<0.01). Our study pointed out that poor dentition and impairment of the swallowing reflex, as a consequence of ethanol intoxication in individuals without mental disorders, were the most important risk factors for bolus death.Journal of Forensic Sciences 01/2011; 56(1):128-31. · 1.24 Impact Factor
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ABSTRACT: The most effective resuscitative procedure in choking by foreign bodies is the Heimlich maneuver, described for the first time by Henry Heimlich (1974) and recognized by the US Surgeon General (1985) as the "only method that should be used for the treatment of choking from foreign body airway obstruction." If performed correctly, this lifesaving maneuver is associated with rare complications, of which the most frequent are rib fractures and gastric or esophagus perforations. Other rare traumatic injuries such as pneumomediastinum, aortic valve cusp rupture, diaphragmatic herniation, jejunum perforation, hepatic rupture, or mesenteric laceration have been described.However, we are unaware of previous reports of splenic rupture after Heimlich maneuver. We present an interesting case of fatal hemoperitoneum due to a hilar laceration of the spleen following a correctly performed Heimlich maneuver.The American journal of forensic medicine and pathology: official publication of the National Association of Medical Examiners 06/2011; 32(2):169-71. · 0.71 Impact Factor
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ABSTRACT: The critical lifesaving steps of BLS are ● Immediate Recognition and Activation of the emergency response system ● Early CPR and ● Rapid Defibrillation for VF. When an adult suddenly collapses, whoever is nearby should activate the emergency system and begin chest compressions (regardless of training). Trained lay rescuers who are able and healthcare providers should provide compressions and ventilations. Contrary to the belief of too many in this situation, CPR is not harmful. Inaction is harmful and CPR can be lifesaving. However, the quality of CPR is critical. Chest compressions should be delivered by pushing hard and fast in the center of the chest (ie, chest compressions should be of adequate rate and depth). Rescuers should allow complete chest recoil after each compression and minimize interruptions in chest compressions. They should also avoid excessive ventilation. If and when available, an AED should be applied and used without delaying chest compressions. With prompt and effective provision of these actions, lives are saved every day.Circulation 11/2010; 122(18 Suppl 3):S685-705. · 15.20 Impact Factor