Foreign body asphyxia

Berzlanovich, Andrea; Fazeny-Dörner, Barbara; Waldhoer, Thomas; Fasching, Peter; Keil, W.

doi:10.1016/j.amepre.2004.04.002

Cited by 38 publications

(15 citation statements)

References 16 publications

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“…Although this information may exist in the dental or food oral processing literature, it was not found given the specified search strategy, and, as previously acknowledged, the term ‘‘chok*’’ was not included in our search. Data regarding solid food particle size after oral processing under both normal and abnormal dental conditions would be interesting to consider alongside autopsy results suggesting that individuals with partial or missing dentition are more prone to choking on food [84]. A recent report by the Japanese Food Safety Commission [85], concludes that food texture (surface smoothness, elasticity, hardness), size, and shape are all relevant with respect to choking risk.…”

Section: Discussionmentioning

confidence: 99%

“…It is not uncommon for coroner’s inquiries into fatal choking episodes in people at risk for dysphagia to conclude that food of an inappropriate consistency was ingested [84, 89–91]. On the basis of the current review, we are obliged to point out that the best available evidence regarding the selection of an optimal food consistency for a person with dysphagia comes from the careful exploration of tolerance for different foods in a comprehensive clinical swallowing assessment.…”

Section: Discussionmentioning

confidence: 99%

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The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review

et al. 2014

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Texture modification has become one of the most common forms of intervention for dysphagia, and is widely considered important for promoting safe and efficient swallowing. However, to date, there is no single convention with respect to the terminology used to describe levels of liquid thickening or food texture modification for clinical use. As a first step toward building a common taxonomy, a systematic review was undertaken to identify empirical evidence describing the impact of liquid consistency and food texture on swallowing behavior. A multi-engine search yielded 10,147 non-duplicate articles, which were screened for relevance. A team of ten international researchers collaborated to conduct full-text reviews for 488 of these articles, which met the study inclusion criteria. Of these, 36 articles were found to contain specific information comparing oral processing or swallowing behaviors for at least two liquid consistencies or food textures. Qualitative synthesis revealed two key trends with respect to the impact of thickening liquids on swallowing: thicker liquids reduce the risk of penetration–aspiration, but also increase the risk of post-swallow residue in the pharynx. The literature was insufficient to support the delineation of specific viscosity boundaries or other quantifiable material properties related to these clinical outcomes. With respect to food texture, the literature pointed to properties of hardness, cohesiveness, and slipperiness as being relevant both for physiological behaviors and bolus flow patterns. The literature suggests a need to classify food and fluid behavior in the context of the physiological processes involved in oral transport and flow initiation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review

et al. 2014

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“…Aside from large airway obstruction-related death which is very familiar to clinicians [15], [16], there are two common entities of aspiration pulmonary syndromes, aspiration pneumonia and aspiration pneumonitis. Mylotte and colleagues estimated 40% suspected pneumonias in nursing home residents to be aspiration pneumonitis based on definite or suspected aspiration event [17], [18].…”

Section: Discussionmentioning

confidence: 99%

Aspiration-Related Deaths in 57 Consecutive Patients: Autopsy Study

Ryu

2014

PLoS ONE

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BackgroundAspiration can cause a diverse spectrum of pulmonary disorders some of which can lead to death but can be difficult to diagnose.Patients and MethodsThe medical records and autopsy findings of 57 consecutive patients in whom aspiration was the immediate cause of death at Mayo Clinic (Rochester, MN, USA) over a 9-yr period, from January 1 2004 to December 31 2012 were analyzed.ResultsThe median age at death was 72 years (range, 13–95 years) and included 39 (68%) males. The most common symptom before death was dyspnea (63%) and chest radiography revealed bilateral infiltrates in the majority (81%). Most common precipitating factors for aspiration were depressed consciousness (46%) and dysphagia (44%). Aspiration-related syndromes leading to death were aspiration pneumonia in 26 (46%), aspiration pneumonitis in 25 (44%), and large airway obstruction in 6 patients (11%). Aspiration was clinically unsuspected in 19 (33%) patients. Antimicrobial therapy had been empirically administered to most patients (90%) with aspiration pneumonia and aspiration pneumonitis.ConclusionWe conclude aspiration-related deaths occur most commonly in the elderly with identifiable risks and presenting bilateral pulmonary infiltrates. One-third of these aspiration-related pulmonary syndromes were clinically unsuspected at the time of death.

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“…Mature individuals with partial or missing dentition are reported to be more prone to asphyxiation from food [8]. In one sample of 120 adults, autopsy reports of asphyxiated foods included: meat, pastries, bread, fruit, vegetables, egg and cheese.…”

Section: Introductionmentioning

confidence: 99%

“…Provision of an incorrect product can result in adverse events. Two hundred autopsy studies of the elderly found that semi-solid foods contributed to a large number of asphyxiations [8]. Coronial inquests have identified staff confusion regarding food textures and their labels as factors specifically noted to contribute to patient death [21••].…”

Section: Introductionmentioning

confidence: 99%

The Need for International Terminology and Definitions for Texture-Modified Foods and Thickened Liquids Used in Dysphagia Management: Foundations of a Global Initiative

Cichero

Steele

Duivestein

et al. 2013

Curr Phys Med Rehabil Rep

287

251

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Conservative estimates suggest that dysphagia (difficulty swallowing) affects approximately 8 % of the world’s population. Dysphagia is associated with malnutrition, dehydration, chest infection and potentially death. While promising treatments are being developed to improve function, the modification of food texture and liquid thickness has become a cornerstone of dysphagia management. Foods are chopped, mashed or puréed to compensate for chewing difficulties or fatigue, improve swallowing safety and avoid asphyxiation. Liquids are typically thickened to slow their speed of transit through the oral and pharyngeal phases of swallowing, to avoid aspiration of material into the airway and improve transit to the esophagus. Food texture and liquid modification for dysphagia management occurs throughout the world. However, the names, the number of levels of modification and characteristics vary within and across countries. Multiple labels increase the risk to patient safety. National standardization of terminology and definitions has been promoted as a means to improve patient safety and inter-professional communication. This article documents the need for international standardized terminology and definitions for texture-modified foods and liquids for individuals with dysphagia. Furthermore, it documents the research plan and foundations of a global initiative dedicated to this purpose.

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Foreign body asphyxia

Cited by 38 publications

References 16 publications

The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review

The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review

Aspiration-Related Deaths in 57 Consecutive Patients: Autopsy Study

The Need for International Terminology and Definitions for Texture-Modified Foods and Thickened Liquids Used in Dysphagia Management: Foundations of a Global Initiative

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