June 30, 2006

The Best Wealth is Your Health

Choking: prevention and first aid

By Dr. Meena Sathappan
Special to the Times

Airway obstruction injury is the leading cause of unintentional injury-related death among infants under the age of 1.

These injuries occur when children are unable to breathe normally because food or objects block their internal airways (choking), materials block or cover their external airways (suffocation) or items become wrapped around their necks and interfere with breathing (strangulation).

Per information from the Centers for Disease Control and Prevention (CDC), in 2000, 160 children ages 14 years or younger died from an obstruction of the respiratory tract due to inhaled or ingested foreign bodies. Of these, 59 percent were caused by food items, and 41 percent by nonfood objects.

Children, especially those under age 5, are particularly vulnerable to airway obstruction death and injury due to their small upper airways, their relative inexperience with chewing and their natural tendency to put objects in their mouths. Parents must be aware of the dangers and risks of choking, especially when children begin crawling, or eating table foods.

What is choking?
Choking occurs when food or small objects get caught in the throat and block the airway. This prevents oxygen from getting to the lungs and the brain. When the brain goes without oxygen for more than four minutes, brain damage or even death may occur. Many children die from choking each year. Most children who choke to death are younger than 5 years of age. Two-thirds of choking victims are infants younger than 1 year of age. Balloons, balls, marbles, pieces of toys, and foods cause the majority of choking deaths.

It is a fact that parents and other caregivers can prevent choking and may find the choking prevention and first aid information (below) useful.

How can you prevent choking?

Feed the right food
Do not feed children younger than 4 years of age any round, firm food unless it is chopped completely. Round, firm foods are common choking dangers. When infants and young children do not grind or chew their food well, they may attempt to swallow it whole. The following foods can be choking hazards:

- Hot Dogs, chunks of meat, cheese or peanut butter
- Nuts and seeds; whole grapes
- Hard, gooey, or sticky candy; raisins
- Popcorn
- Raw vegetables
- Chewing gum

Keep ‘dangerous’ household items away
Below are some examples of items that you should keep away from infants and children.

- Latex balloons, coins, marbles, small balls
- Toys with small parts or that compress to fit entirely into a child’s mouth
- Pen or marker caps; small button-type batteries; medicine syringes

Learn CPR
Learn basic life support procedures like Cardiopulmonary Resuscitation (CPR)

Supervise and make children eat at the table
Insist that they are at least sitting down. They should never run, walk, play, or lie down with food in their mouths

Feed small pieces and make them chew
Cut food for infants and young children into pieces no larger than one-half inch and teach them to chew their food well. On a related front, “chew before you swallow,” said President George W. Bush in response to him passing out after choking on a pretzel!

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.

Follow the age recommendations on toy packages
Age guidelines reflect the safety of a toy based on any possible choking hazard as well as the child’s physical and mental abilities of various ages.

Keep all areas clean
Check under furniture and between cushions for small items that children could find and put in their mouths.

Additional information on choking and prevention can be found at:

Overview and prevention information
http://www.nlm.nih.gov/medlineplus/choking.html

First aid for choking
http://www.ou.edu/oupd/choke.htm

Source: American Academy of Pediatrics & www.usa.safekids.org

Dr. Meena Sathappan is a board-certified Pediatrician who lives and practices in Evergreen. She is available for questions and consultation at Aasha Pediatrics, 2060 Aborn Road, # 230, San Jose, CA 95121 (corner of Aborn Road and Capitol Expressway). You can call her at 408-274-9099, or e-mail her at msathappan@gmail.com. Website: www.aashapediatrics.com