Aspiration pneumonia can lead to hospitalization. If you believe that you are experiencing an abnormal swallow, see a Speech-Language Pathologist. Speech-Language Pathologists can identify if there is a problem and how to support a health, safe swallow.
Powered by WordPress and Live Wire. Published by Riverview Health on May 20, What are signs of problematic swallowing?
Normally, the epiglottis keeps food and drink from going down the windpipe. This sturdy flap of cartilage is designed to snap shut automatically when we swallow, closing off the airway and shunting the sustenance down the esophagus to meet its digestive fate.
Another automatic body function, the gag reflex, sometimes keeps unwanted objects out of the upper respiratory tract by triggering a reverse contraction of throat muscles.
We gag for many reasons; sometimes it's just a matter of tissues in the throat getting irritated. Gagging can feel like choking, but it's not the same. In fact, the gag reflex can prevent choking by clearing the throat of an unwanted substance. Choking is most likely to occur in very young children, particularly toddlers, and in the elderly.
Toddlers, those wonderfully curious creatures, like to explore their surroundings with their mouths — which often means putting things in them. If you've ever shopped for a toy for a young child, you've probably seen the choking hazard warning on items with small pieces.
Older people are vulnerable because they lose some of the reflexes and muscle tone needed to eject an object from the trachea. A condition like Parkinson's disease makes an older person even more vulnerable. Cognitive disorders like Alzheimer's disease can lead to swallowing difficulties and a greater likelihood of choking. Drinking can be a contributing factor because alcohol suppresses the airway's protective reflexes. But once you know the signs of choking, they're easy to spot even without medical training.
They include. When you see someone choking, speed is of the essence. Without adequate oxygen, the person will quickly lose consciousness and could suffer permanent brain damage in as little as four to five minutes.
First ask him or her, "Are you choking? Don't perform the Heimlich maneuver on anyone who's able to talk. Toby Nagurney, an emergency department physician at Massachusetts General Hospital. In this situation, encourage the person to continue breathing and to cough forcefully, which is the best way to dislodge items stuck in the airway. Food is the most frequently aspirated type of object, with nuts and seeds being particularly common.
Liquids, such as water, can also be inhaled into the airways. In addition to edible objects, other non-edible items which are commonly retrieved from the airways include: [2] [4] [8].
Good to know: Certain objects, such as some pen caps, have small holes built into them. This can help to provide a passage of air and lessen the risk of suffocation in the event they are accidentally inhaled.
Age is a primary risk factor for foreign body aspiration, and approximately 80 percent of instances occur in young children under the age of three years old. However, foreign body aspiration can occur at any age. According to one study, the median age for foreign body aspiration in adults is 60 years old. Other risk factors for foreign body aspiration include: [6] [8]. Good to know: Young children and people with neurological or psychiatric disorders are also at higher risk of receiving a delayed diagnosis, because they may not be able to provide an immediate account of their symptoms.
Rapid diagnosis is extremely important for foreign body aspiration, because a significant obstruction in the airways that is restricting breathing can quickly become life-threatening. After assessing the symptoms, if a doctor suspects a significant airway obstruction, emergency treatment will likely be sought to remove the object, without any further need for imaging tests.
However, if the affected person is stable and displaying symptoms of a mild or historic foreign body aspiration, further tests may be recommended before treatment. A doctor might choose to perform a physical examination first, which can include: [2] [8]. If foreign body aspiration is still suspected, a doctor may recommend an imaging test in order to gain an internal view of the body. An X-ray is usually the first imaging test suggested.
However, not all objects are visible on radiograph tests such as X-rays. If an X-ray is inconclusive, a CT scan may then be recommended. Good to know: As well as detecting the presence of a foreign body in the airways, imaging tests may also be able to identify certain possible complications of the aspiration, such as any collapse of a lung. If imaging tests are inconclusive, a bronchoscopy might be suggested to help diagnose a foreign body aspiration. During a bronchoscopy, a long, thin tube called a bronchoscope is typically inserted through the mouth to gain an internal view of the airways.
The bronchoscope has a light source and camera on one end, which allows the doctor to see areas such as the larynx, trachea and bronchi up close. In the case of foreign body aspiration, a bronchoscopy can either be used diagnostically, to confirm the presence and location of a foreign body in the airways, or as a treatment method to physically remove the item. Treatment of foreign body aspiration involves managing the person's ability to breathe and removing the foreign body.
It is extremely important to respond quickly if the affected person has a significant obstruction that is affecting their ability to breathe, as this can quickly become life-threatening. If an airway obstruction is suspected, it is important to deliver first aid quickly. Both mild and severe choking can be successfully treated at the scene, and this should take precedence over immediately calling for emergency medical care.
When someone is displaying signs of choking, the following steps can be used to help remove the object: [18] [19] [20]. If the above measures are unsuccessful, call for emergency medical help and then continue alternating between back blows and abdominal thrusts until assistance arrives.
If the person becomes unconscious, lay them on a flat surface and begin to deliver cardiopulmonary resuscitation CPR , even if a pulse is present. Good to know: The above advice is appropriate for adults and children over the age of one year. For information about what to do if a baby is choking, see this resource on first aid for a baby who is choking. If further attempts at first aid are unsuccessful and once medical help arrives, an emergency endotracheal intubation may be attempted.
The tube can assist in opening the airways to provide oxygen and can also be used to remove blockages. In the most severe cases of choking, an emergency tracheotomy may be performed. A tracheotomy involves creating a small opening at the front of the neck. A tube is then inserted through this opening into the trachea, helping the person to breathe. People who have milder cases of foreign body aspiration may not require emergency medical treatment.
However, prompt treatment is usually still necessary, because a foreign body in the airways can quickly cause other health complications , such as a respiratory infection like pneumonia.
Removal of the foreign body during a bronchoscopy is a common, and usually successful, treatment method for inhaled objects located in the trachea or bronchi. A bronchoscope is a long, thin tube with a camera and light source on one end. As well as helping to locate the foreign body, certain surgical instruments, such as forceps or a suction pad can be attached to the bronchoscope to enable removal of the object.
Once the item is removed, the doctor will usually return the bronchoscope to the airway to ensure no fragments of the foreign body remain. If the object is located in the larynx, a similar treatment method known as a laryngoscopy may be used instead.
Surgical removal is rarely necessary for foreign body aspiration. Removal of an aspirated foreign body located in this region can then be attempted through the surgical opening. Tracheotomies are usually performed under general anesthetic, meaning the patient is unconscious. This is also performed under general anesthesia and is usually only suggested if the foreign body is located in the bronchi, and bronchoscopic attempts to remove the foreign body have been unsuccessful.
Medication is typically not prescribed to treat foreign body aspirations. However, antibiotics may be prescribed to target any bacterial infections that arise as a result of the condition. Because foreign body aspiration occurs most commonly in children under the age of three, it is important to educate caregivers about the condition, so they can help prevent the children in their care inhaling small objects.
Preventive suggestions include: [4] [5] [28] [29]. Although common in children, foreign body inhalation can occur to anyone at any age. Avoid putting non-edible objects into the mouth, and always take care to eat slowly. In the most severe cases of foreign body aspiration, the inhaled object can cause choking, and impaired breathing function. Unless the object is urgently removed, the condition may become fatal.
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