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.
Article: [Panendoscopy].Revista de gastroenterologia de Mexico 01/1988; 49(3):151-6.
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ABSTRACT: Signs and symptoms of adult FB aspiration are most often nonspecific. Misdiagnosis and delay in diagnosis frequently occur. Radiographic evaluation is helpful, but flexible bronchoscopy is the gold standard in the identification and localization of an airway foreign body. With increasing experience and development of better accessories, removal using a flexible bronchoscope under local anesthesia can be performed safely and successfully. Review of large series of FB removal indicates a success rate of 86% in more than 400 procedures with flexible bronchoscopy.Clinics in Chest Medicine 07/2001; 22(2):319-30. · 2.07 Impact Factor
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ABSTRACT: Food asphyxiation is a common problem whenever and wherever people eat. A knowledge of predisposing factors might help to prevent this problem. We reviewed 34,476 consecutive autopsies done during a 14-year period (1984 to 1997) at the Institute of Forensic Medicine, Vienna. Demographic features and predisposing factors were determined for the 191 cases of fatal foreign body asphyxiation. Old age, poor dentition, and alcohol consumption were frequent findings. Other risk factors included chronic disease, sedation, and eating risky foods. On 120 (63%) of the 191 occasions, observers were present at the time of the incident and subsequently called the Emergency Service. In 110 (92%) cases, neither the observers nor the majority of the emergency medical technicians and physicians who would have been able to intervene recognized the definite diagnosis. Only 10 cases were correctly identified during cardiopulmonary resuscitation. These fatal accidents could be prevented easily. Effective prevention depends on understanding the nature and frequency of accidental deaths due to asphyxiation and the factors that lead to their occurrence and having a high degree of suspicion.The American Journal of Medicine 11/1999; 107(4):351-5. · 4.77 Impact Factor