Deaths Associated with Choking in San Diego County

Abstract

Death from choking is the fourth most common cause of unintentional-injury mortality, but little data are published on causes or locations of these episodes. These deaths typically are peaked at the extremes of age, with young children and the elderly having the greatest rate of fatal choking. Our objective was to characterize the causes of fatal airway obstruction in adults. The San Diego County Medical Examiner's database was searched for deaths attributed to choking in decedents 18 years and older during the 10-year period from 1994 to 2004. Data were abstracted regarding the underlying medical conditions, items choked on, location of the choking, and treatments involved in the individual cases. We found 133 victims who died from choking, with 14% having using alcohol or other sedatives and 55% having a documented neurological deficit or anatomic difficulty with swallowing. The most common specified food objects that victims choked on were meat products, and 45% occurred at home, followed by 26% at supervised facilities, and 14% at restaurants. Of the 19 choking episodes occurring in restaurants, only one employee was documented to attempt a resuscitative effort. Most victims who choked to death had an underlying neurological deficit, and occurred at home or supervised facilities appear to have an appropriate initial-response intervention.

Part 5: Adult Basic Life Support

“…273 Most reported cases of FBAO occur in adults while they are eating. 274 Most reported episodes of choking in infants and children occur during eating or play when parents or childcare providers are present. The choking event is therefore commonly witnessed, and the rescuer usually intervenes while the victim is still responsive.…”

Food-related choking deaths among the elderly

“…Although the risks are acknowledged for those in long-term care, the dangers of food suffocation among older people are not as well known in the general population 20. Eating semi-solid foods such as peanut butter, having poor dentition and consuming alcohol and medication such as sedatives and antipsychotic drugs are all risk factors for food suffocation among older adults 2 4 21 22. Despite the awareness of choking risks in medical and long-term care situations, one-quarter of the food choking events among older decedents occurred in a residential institution such as a nursing home.…”

Aspiration Deaths Among Adults in Istanbul

“…The median age of 200 cases investigated by Berzlanowich et al is 65, and 53% of the cases were over 65 years (7). Elderly distribution is clear in the study of Dolkas et al with a median age of 73 years (8). The mean age of the adults in series of Wick et al is 68.9 years with a range of 30 to 96 years.…”

“…Underlying neurological disorder is the major risk factor for aspiration, especially in the elderly (3,6,7,8). In our study, only one case had a clinical history of hemiplegia, four cases had psychiatric diseases and two of them were under treatment in different psychiatry clinics.…”