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Choking or foreign body airway obstruction occurs when an object partially or completely obstructs the passage of air exchange between the upper airway and the trachea. Choking can be seen in individuals of any age, however, it tends to occur with the greatest frequency in either the very young or the elderly population. In the very young, the foreign body is often food, a toy, a coin, or even a battery, whereas in the elderly it is almost always food. This activity describes the causes of choking, reviews the presentation and diagnosis, and highlights the role of the interprofessional team in its management. Objectives: Describes the etiology of choking. Describe the presentation of a patient who is choking. Describe the evaluation for choking. Explain the importance of optimizing care coordination amongst interprofessional team members to improve outcomes for patients affected by choking. Access free multiple choice questions on this topic.

Choking or foreign-body airway obstruction occurs when a foreign body, such as food, coins, or toys, wholly or partially obstructs airflow from the upper airway into the trachea. Choking affects either the very young or the elderly.[1] In the young, the foreign body is likely to be food or a toy, while in the elderly, it is almost always food. There is a bimodal distribution of patient ages, affecting primarily the young (ages 1-3) and the elderly (ages 60+). In 2015, 5,051 people died from choking. Of those, 2,848 (56%) were aged 74 or above. Choking is the 4th leading cause of unintentional death,  the leading cause of infant death, and the 4th leading cause of death among preschool children.[2] The most common objects that cause choking among children are food, coins, balloons, and other toys. In a Center for Disease Control review of nonfatal choking episodes in children that were treated in the emergency department, 13% of choking episodes were associated with coins, and 19% were caused by candy or gum. Latex balloons are the most likely fatal aspirated foreign body, accounting for 29% of deaths by foreign body aspiration between 1972 and 1992. In the same time period, hot dogs were the most fatal food aspiration, accounting for 17% of food-related aspiration fatalities.[3] Of the adult fatalities associated with choking, there is a strong association with dementia (including Alzheimer disease) and Parkinson disease.[4] Decreased salivation in the elderly is also implicated, as this impairs the ability to transfer food during swallowing.

Choking events are fairly common in both adults and children. In minutes, they may lead to a fatal outcome. In a hospital setting, the best results are achieved when clinicians are familiar with methods to relieve choking and when appropriate assistance is provided promptly. Caregivers should work toward educating the public on methods of responding to a choking event.