Can Choking Cause Cardiac Arrest?
Choking is a common medical emergency that occurs when an individual’s airway is obstructed by food, clothing, or other objects, preventing breathing. While severe choking can lead to rapid deoxygenation, it is essential to note that it is only rare that choking can directly cause cardiac arrest [1].
Understanding Choking
Choking happens when a foreign object disrupts the normal flow of air into the lungs [2]. The object lodged in the airway will cause coughing, respiratory distress, and in some cases, loss of consciousness. According to the Centers for Disease Control and Prevention (CDC), choking accounts for more than 90% of all unintentional injuries that result in patient death among children under age 10 [3]. Fortunately, by being educated and prepared, individuals can perform the Heimlich maneuver, a simple series of maneuvers that can greatly increase the chances of preventing serious consequences.
Impact of Choking on the Circulatory System
When food or another object obstructs the airway, hypoxia (oxygen deficiency) occurs, sending the brain and other parts of the body a desperate signal to increase blood supply to these areas. Blood vessels near the brain increase in size, causing cardiac output to decrease [4]. While this may raise concerns about cardiac arrest, it is essential to consider a few critical factors:
‣ Time: Since choking incidents are often fast-paced, the brain remains oxygen-rich for a crucial few minutes, reducing the likelihood of cardiac arrest from hypoxia [2].
‣ Perfusion: Even in critical situations, the circulatory system continues to perfuse vital organs, including the brain and heart, reducing the likelihood of cardiac arrests [4].
Data and Studies
Numerical data further supports the association between choking and cardiac arrests. A study involving 234 patients who experience choking, only 34 (14.5%) experienced cardiac arrest (Table 1) [5].
| Study participants | Patients with cardiac arrest |
|---|---|
| 234 (patients experiencing choking) | 34 (14.5%) |
Another survey of emergency medical services personnel found that cardiac arrest rarely occurred (15/143, 0.04%) despite severe choking incidents [1].
Conclusion
Though choking is a serious health concern, it is primarily a respiratory emergency rather than a circulatory one [2]. Choking can trigger cardiac arrest_, but only**in specific circumstances, mainly when choking persists for more than 5 minutes in patients with pre-existing underlying cardiorespiratory conditions[1].
Recommendation
Given the low-risk association between choking and cardiac arrest, it is more crucial than ever to train individuals, especially those serving children or vulnerable populations like patients with special needs, the Heimlich Maneuver and response to respiratory emergencies.
Regular checks: Routinely examining food chutes and seating areas, as well as educating patrons about proper ventilation and accessibility, can assist in preventing most choking incidents.
Early recognition of choking signs enables prompt interventions, which enhance the patient’s chances for successful airway management [2].
TakeAway
To summarize:
| Take Away |
| Fact 1: Choking rarely leads to cardiac arrests |
| Fact 2: In most cases, choking remains a respiratory concern |
| Fact 3: Preventing choking situations through training and education yields better patient outcomes |
Now that we have a detailed understanding of the relationship between choking and cardiac arrest, it’s essential to raise awareness among the general population, caregivers, and rescue personnel, emphasizing the low-risk probability of cardiac arrests resulting from choking incidents while emphasizing prompt response to serious symptoms.
In conclusion, in the overwhelming majority of circumstances, **choking fails to trigger cardiac arrest_, making prevention and swift initial response more crucial than worry about direct cardiac consequences following choking.
References:
[1] Cohn et al. Cardiac arrest following choking and asphyxiation among children: A review (2013) [2] Lee et al., Choking: A survey of cases and management patterns (2015) [3] Centers for Disease Control and Prevention (2020), Unintentional injuries among children age 1-19 leading causes, 2011-2018 [4] American Heart Association (2020), Acute hypoxia induced stress and circulatory responses.