Deaths Associated with Choking in San Diego County
Department of Emergency Medicine, University of California, San Diego, San Diego, California, United StatesJournal of Forensic Sciences (Impact Factor: 1.16). 12/2006; 52(1):176 - 179. DOI: 10.1111/j.1556-4029.2006.00297.x
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: Foreword by Dr Ruth Hussey OBE[Show abstract] [Hide abstract]
ABSTRACT: Obesity and the use of alcohol are two of the major threats to the public's health. Both are linked to cancer, heart disease and a variety of other major killers that prematurely end many people's lives and create years of poor health. All too often we address these issues in silos with expertise in food and in alcohol but with the overlap between the two being poorly understood by professionals and consequently under-utilised in the pursuit of improving the public's health. Little professional understanding means the public are not in possession of the information they need to make healthy choices about food and alcohol. Encouraged by advertisements and marketing, consumers can adopt poor food and high alcohol diets without realising both will contribute to their risks of long term disease. Individuals may also skip food in order to get drunk more quickly or try to eat certain food types in order to delay inebriation but have little understanding of the health consequences of either action. It is essential that we consider food and alcohol together; improve our understanding of the substantial overlaps between these two issues; and ensure the public are aware of the dangers and benefits that food and alcohol together represent. This report is a first step in this process and, while it is far from comprehensive, outlines much shared territory which we need to understand. I hope people working on food, alcohol and generic public health issues find it of interest and that it leads to new opportunities to tackle the burden of ill health created by the widespread over consumption of food and drink.
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ABSTRACT: In the present study, a 42 y.o. woman lethal case by aspiration of a foreign body is reported. During the autopsy, a large chewing-gum piece was found above the aditus ad laringem, so as to completely obstruct its access, causing a lethal respiratory insufficiency. The anatomopathological exam of the lungs showed the signs of acute asphyxia. The toxicological analyses of blood and urine samples were negative for drugs and/or ethanol. An accurate literature study allowed to show that this case represents the second lethal event related to the aspiration of a chewing gum in an adult subject, and the first related to the complete obstruction of the aditus ad laringem. 33 A s widely known, asphyxia by choking is caused by the introduction of a foreign body into the respiratory tract, able to obstruct the air passage. Asphyxia by choking is widely discussed in literature [1-2]. It regards mainly food (death by cud), or foreign bodies inhaled by infants (i.e.: buttons, coins, balls, etc.) or by elderly subjects (i.e.: partial denture), although it can occur at any age [3-7]. Though being a dangerous event, the obstruction of the airways by foreign body is rarely mentioned in current medical textbooks or journals, and remains a largely uninvestigated cause of lethal asphyxia in adults. In this respect, specific risk factors have been identified, such as neurological and/or psychiatric diseases, consumption of central depressant drugs or inhibiting the pharyngeal or coughing reflex, age, irregularities of the teeth, loss of consciousness, cranial or facial trauma [8-10]. The diagnosis of death by choking is based on the detection of the generic signs of asphyxia, on the identification of the foreign body obstructing the airways and on the exclusion of other causes of death. The context of the event is needed to give a coherent explanation. In the present study, a lethal asphyxial event by aspiration of a piece of chewing-gum is reported. The accurate analysis of Literature shows that cases of choking by chewing-gum are very rare [3-4]: Njau described a fatality resulted from the partial obstruction of the extent of the trachea ; the study of Haftoura et al. regards a non-lethal case of choking by a pre-operative piece of chewing-gum adhering to a well-functioning endotracheal tube . The case here reported regards a singular case of complete obstruction of the aditus ad laringem due to the accidental aspiration of a large piece of chewing-gum.Romanian Journal of Legal Medicine 01/2012; 20(1). DOI:10.4323/rjlm.2012.33 · 0.23 Impact Factor
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ABSTRACT: Alcohol consumption in the older adult is of major concern with the advent of baby boomers coming into the over 65-age bracket. Alcohol consumption has been touted as beneficial for health, and while that may be accurate for moderate consumption in younger persons, there is considerable risk associated with increased alcohol intake in older adults. This increase is partially due to age-related physiological changes, existing diagnoses, number of comorbid conditions, and increased use of prescribed and/or over-the-counter medications, coupled with other concerns. This review addresses the current research regarding ethanol consumption in older adults and all-cause mortality as well as several conditions more frequently seen in the geriatric population. These conditions include vascular diseases, hypertension, type 2 diabetes, gastrointestinal disorders, hepatic disorders, dental and oro-facial problems, bone density decline, and falls and fractures. In addition, drug interactions and recent research into select vitamin and mineral considerations with increased alcohol intake in older persons are addressed. While recommendations for alcohol intake have not been specifically established for age ranges within the 65-year-and-older bracket, and practitioners do not routinely assess alcohol intake or ethanol related adverse events in this population, common sense approaches to monitoring will become increasingly important as the generation of "boomers" who believe that alcohol intake improves health comes of age.Journal of Nutrition for the Elderly 07/2009; 28(3):203-35. DOI:10.1080/01639360903140106
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