Introduction to Choking Hazards
It was the scariest choking incident David Palumbo had ever seen. The 88-year-old man had been dining at a Providence, Rhode Island, Italian restaurant in September 2019. Now he was unconscious, with a piece of bread lodged in his windpipe. Precious minutes went by as first responders were unable to help him with CPR or the Heimlich maneuver. In an ambulance on the way to the hospital, the elderly man’s skin was blue, and firefighters worried he was going to die. Palumbo — a fire department captain — used a scissors-like device called Magill forceps to pull the bread from the man’s throat. “We get a lot of calls in the city for choking,” many of which are resolved before emergency responders even get there, Palumbo added. “This was by far the worst one I’ve been on in my career." Fortunately, the man survived and made a full recovery, he said.
The Risks of Choking Among the Elderly
But many elderly people do not. Each year, choking claims the lives of more than 4,100 Americans who are 65 or older. It’s the most vulnerable age group, accounting for about three-quarters of U.S. choking deaths, according to federal health statistics. The death rate has been relatively steady, but the number has risen, as the size of the nation’s retirement-age population grows.
Anti-Choking Devices: A Potential Solution?
In response, a number of companies are marketing anti-choking devices to the elderly. Medical professionals have been debating whether to endorse the products, sold under the names LifeVac, SaveLix, VitalVac and the Dechoker. Dr. Nathan Charlton, a University of Virginia professor of emergency medicine who advises the American Red Cross on first aid, said there is limited evidence for the products and that the Red Cross is still evaluating them.
Understanding Choking
What is Choking?
Choking occurs when food or some other object partially or totally blocks the windpipe, preventing oxygen from reaching the lungs. Telltale signs include someone reaching for their neck and losing the ability to speak normally. Brain damage can occur after four minutes, and death can come just a few minutes later.
Why are Older Adults at Higher Risk?
Older adults are at higher risk for a number of reasons. As people get older, mouth and throat muscles can weaken. Older people also make less saliva. Some chronic diseases and medications can make swallowing even harder. Dentures can be a choking risk.
Preventing Choking Deaths
The Best Ways to Stop Choking
Choking risk can be reduced by cutting food into small pieces, chewing food slowly, drinking plenty of liquids with meals, and not laughing or talking at the same time you are chewing and swallowing. When someone is choking, you can try perhaps the oldest form of first aid: back slaps. There’s also the Heimlich maneuver, named after the doctor credited with devising it in the 1970s. It involves standing behind the choking person, wrapping your arms around their abdomen and — with a balled fist — thrusting inward and upward. The idea is that it forces air out of the lungs, and the obstruction with it. The American Red Cross recommends alternating back blows and abdominal thrusts in sets of five.
The Role of Anti-Choking Devices
How Do Anti-Choking Devices Work?
Makers of some the newer anti-choking devices say that’s where their products can make a difference. “Elderly people probably are not capable of diving on a chair or counter,” said Arthur Lih, the founder and chief executive of LifeVac. They vary in design, but generally the devices look like a face mask attached to a tube or bellows, with a handle at the end. They typically sell for around $30 to $100. A choking person dons the mask, pushes down on the handle and then pulls up. That is supposed to create a suction that would pull out the blockage.
Safety Concerns
Some research suggests at least certain devices can injure the tongue or cause bleeding and swelling in the throat. And the U.S. Food and Drug Administration has reports that some products did not generate enough suction and left people with bruising around the face, lips, and mouth. An injury report led the FDA to do an inspection and issue a warning letter to Dechoker in 2021. Manufacturers note their products are registered with the FDA, but that’s not the same as an endorsement. Indeed, the agency last year issued a notice to consumers that said it has not approved anti-choking devices sold over the counter, because their safety and effectiveness haven’t been established.
Conclusion
Choking is a significant risk for older adults, and while anti-choking devices may offer a potential solution, more research is needed to determine their effectiveness and safety. The consensus among medical professionals is that back blows and abdominal thrusts should always be tried first. As the population ages, it’s essential to continue exploring ways to prevent choking deaths and to educate the public on the best methods for responding to a choking emergency.
FAQs
- Q: What is the most common age group affected by choking deaths?
- A: The most vulnerable age group for choking deaths is people 65 or older, accounting for about three-quarters of U.S. choking deaths.
- Q: How can choking risk be reduced?
- A: Choking risk can be reduced by cutting food into small pieces, chewing food slowly, drinking plenty of liquids with meals, and not laughing or talking at the same time you are chewing and swallowing.
- Q: What is the Heimlich maneuver?
- A: The Heimlich maneuver involves standing behind the choking person, wrapping your arms around their abdomen, and with a balled fist, thrusting inward and upward to force air out of the lungs and the obstruction with it.
- Q: Are anti-choking devices effective?
- A: There is limited evidence for the effectiveness of anti-choking devices, and more research is needed. The American Red Cross and other medical professionals recommend trying back blows and abdominal thrusts first.
- Q: Can anti-choking devices cause injury?
- A: Yes, some research suggests that anti-choking devices can cause injury, including tongue injury, bleeding, and swelling in the throat, as well as bruising around the face, lips, and mouth.
