Clinical and demographic data in 75 patients with near-fatal choking episodes

Abstract

The clinical background and circumstances of 75 patients who had survived a near-fatal choking episode, i.e., had undergone a Heimlich maneuver, oropharyngeal suctioning, or intubation, is reported. Sixty had choked on a solid bolus (often of a complex texture like sandwiches and chicken soup). Four patients had choked on mashed banana. In 30 patients neurologic disease (such as cerebrovascular disease, Parkinson disease, or dementia) was present. Choking occurred during breakfast (16 patients), lunch (21), dinner (26), and snacks (12). Twenty-five choked at home, 18 in nursing homes, 14 in hospitals, nine in restaurants, and nine in drinking establishments. Twelve were being fed at the time of choking. Fifty-eight of the individuals had oral, pharyngeal, or esophageal abnormalities on radiographic examination that could explain the choking episode. Fourteen patients who were able to vocalize during the choking episode had probably suffered from esophageal impaction. Our study indicates that elderly individuals and those with neurogenic dysphagia are at risk for choking. Dysphagia diet (semisolids) may actually contribute to the risk in these patients. Young adults may also be at risk during episodes of consumption of alcohol and snacks.

Social and Psychological Burden of Dysphagia: Its Impact on Diagnosis and Treatment

“…About 20% of stroke patients with dysphagia develop aspiration pneumonia [8]. Near-fatal choking episodes and deaths caused by aspiration are common in elderly patients in hospitals or institutions [9,10].…”

Dysphagia is a Common and Serious Problem for Adults with Mental Illness: A Systematic Review

“…(''ECT'') of (MH ''Electroconvulsive Therapy'') S24 S1 or S2 or S3 or S4 or S5 S25 S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13 or S14 or S15 or S16 or S17 or S18 or S19 or S20 or S21 or S22 S26 S24 and S25 [4] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [5] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [27] Review article [28] Commentary [29] Letter to the editor with case report [30] Study not related to dysphagia [31] Duplicate data presented in [31] which was included in the review [32] Review of another author's work. Not original article [33] Case report [34] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [35] Commentary [36] Letter to the editor [37] Letter to the editor [38] Outcomes for general population (not limited to population of interest) [39] Case report [40] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [41] Review article [42] Abstract from conference proceedings [43] Unable to locate article [44] Outcomes for general population (not limited to population of interest) [45] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [46] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [47] Letter to the editor [48] Single-case studies [49] Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [50] Letter to the editor [51] Letter to the editor with single-case report [52] Commentary [53] Letter to the editor [54] Medication guideline. Neither dysphagia frequency outcome nor dysphagia intervention outcome documented [55] Neither dysphagia frequency ou...…”

Texture-modified meals for hospital patients

“…For example, meat, poultry, popcorn, nuts and hard candy are also noted as choking risk items for adults (Ekberg and Feinberg, 1992). For example, meat, poultry, popcorn, nuts and hard candy are also noted as choking risk items for adults (Ekberg and Feinberg, 1992).…”

“…Although meat is the most common food choking item, in the older population the additional food textures of dry foods (bread, toast, cracker, donut), semi-solid foods (cereal, puree, mashed banana) and 'complex textures' (sausage on a bun, sandwiches, meatballs, meat and vegetables/noodles) have also been found to cause asphyxiation (Ekberg and Feinberg, 1992;Irwin et al, 1977;Berzlanovich et al, 2005). Berzlanovich et al (2005) documented the consistency of asphyxiated food materials.…”