Foreign body asphyxia A preventable cause of death in the elderly

Berzlanovich, Andrea; Fazeny-Dörner, Barbara; Waldhoer, Thomas; FASCHING, P; Keil, W.

doi:10.1016/s0749-3797(04)00077-7

Cited by 50 publications

(86 citation statements)

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“…In individual cases, objects like coins, dentures and layers of gauze used in oral hygiene were found in the larynx. More recent studies demonstrate that fatalities among the elderly may also be caused by soft impacted food boluses (Berzlanovich et al 2005). It has long been established that alcohol has an activating effect on the parasympathetic nervous system and an inhibitory effect on the sympathetic system.…”

Section: Frequency/occurrencementioning

confidence: 99%

Injuries due to Asphyxiation and Drowning

Keil¹,

Lunetta²,

Vann³

et al. 2014

Handbook of Forensic Medicine

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Section: Frequency/occurrencementioning

confidence: 99%

Injuries due to Asphyxiation and Drowning

Keil¹,

Lunetta²,

Vann³

et al. 2014

Handbook of Forensic Medicine

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“…Semi-solid foods pose the highest risk of choking: 4 the US Food and Drug Administration and the Food Standards Agency (UK) have issued warnings of the dangers of choking on a jelly containing konjac. 5,6 Konjac jelly does not dissolve readily and its surface becomes smooth and slippery when placed in the mouth.…”

mentioning

confidence: 99%

Influence of body position during Heimlich maneuver to relieve supralaryngeal obstruction: a manikin study

Ichikawa

Oishi

Mochizuki

et al. 2017

Acute Medicine & Surgery

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Aim: To study the most effective body position for Heimlich maneuver. Methods: A choking simulation manikin was connected to a laryngeal model of a child or an adult, and a differential pressure transducer recorded the airway pressure and waveform during the maneuver. A konjac jelly was placed on the larynx to mimic complete supralaryngeal obstruction. The maneuver (five successive compressions) was carried out six times each in standing, prone, and supine positions. For cases of children, we added a supine position with a pillow under the back.Results: In the adult model, airway obstruction was more frequently relieved in the supine and prone positions than in the standing position (P < 0.001). In the child model, airway obstruction was more frequently relieved in the supine position, with a pillow, and in the prone position, than in the standing position (P < 0.001). Without relief, successive Heimlich maneuvers made the airway pressure increasingly negative (adult, from À21.9 AE 6.5 cmH 2 O to À31.5 AE 9.1 cmH 2 O in the standing position [P < 0.001]; child, from À15.0 AE 9.5 cmH 2 O to À30.0 AE 9. Conclusions: The Heimlich maneuver was more effective in the supine and prone positions. In children, the prone position may be most effective. Successive Heimlich maneuvers may be harmful when the airway is not relieved after the first compression.

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“…The aspirated materials were unspecified food in 7 cases, bread and traditional food made from leaven and mince in 4 cases, meat in 2 cases, chewing gum in 3 cases and gastric content in 7 cases (Table 2). According to Berzlanovich et al aspiration in the elderly, was characterized by a significantly higher on soft or slick foods, and was contrasted by young's who choked on large pieces of foreign material with a higher rate of alcohol concentration as observed in our cases 5,8,10, and 23 (7).…”

Section: Discussionmentioning

confidence: 44%

“…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.…”

Section: Discussionmentioning

confidence: 60%

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Aspiration Deaths Among Adults in Istanbul

Asil¹,

Özdemir²,

Üzün³

et al. 2014

Bull Leg Med

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Massive aspiration of food is rare, but most common in people under the influence of alcohol or a drug and comatose patients who have impaired functioning of the central nervous system. The finding of small amounts of food material in the airway at autopsy does not indicate the true vital aspiration because of agonal or even early post-mortem overspills. Occlusion of the small airways, mainly the membranous and respiratory bronchioles, partial or total filling of bronchiolar lumen and the alveolar spaces with food or gastric content were typical morphologic findings. In our 10 year retrospective study we presented the data of 21 male and 4 female cases with a final diagnosis of fatal aspiration in age from 23 to 78 years (45.43±14.61) from the records of Morgue Specialization Department of the Council of Forensic Medicine. 13 cases found death at the scene without an eyewitness. All deaths were accidental in manner except one homicide. Toxicological analysis revealed blood alcohol concentration levels between 161 and 339 mg/dL in 7 cases. Morphine metabolites, benzodiazepine and barbituric acid derivatives, toluene and acetone were detected in 5 subjects. Aspirated materials were food in 14 cases, chewing gum in 3 cases, gastric content in 7 cases and a fabric gag in one case.The history, other evidence of external vomit on the clothing or immediate surroundings and toxicological analysis are by no means as significant as autopsy findings especially in cases of aspiration.Key words : adult; aspiration; death; autopsy

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Foreign body asphyxia A preventable cause of death in the elderly

Cited by 50 publications

References 0 publications

Injuries due to Asphyxiation and Drowning

Injuries due to Asphyxiation and Drowning

Influence of body position during Heimlich maneuver to relieve supralaryngeal obstruction: a manikin study

Aspiration Deaths Among Adults in Istanbul

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