Choking (Cafe Coronary)

What is "cafe coronary?"

"Cafe coronary" is poorly named because it has nothing to do with a heart attack. This condition got its name because onlookers may think they are witnessing a heart attack when a diner is really choking to death. "Cafe coronary" is blockage in the upper airway, usually caused by food or vomit stuck in the throat. The blockage causes choking and can be life threatening.

How does choking occur?

Choking occurs when a piece of food or some other object gets stuck in the airway. Chicken, fish bones, and pieces of meat that have not been chewed properly get stuck in the throat easily. If you have been drinking alcohol, your risk of choking is greater because you may be careless about chewing food well.

What are the symptoms?

Symptoms of choking may include:

• inability to talk
• wheezing
• forceful coughing
• clutching the throat or chest as a sign of distress
• fainting.

How is it treated?

If a person is choking but still able to breathe and cough and not turning a bluish color, let him or her try to cough up the object. If he or she is having trouble breathing and turning blue, give first aid by doing the Heimlich maneuver, which is described in the next section.

Emergency treatment may be necessary. If an object can't be removed and the windpipe is completely blocked, the person may need an emergency operation called a tracheotomy. This is a procedure in which the health care provider makes a cut through the skin of the throat and into the windpipe. He or she then inserts a tube into the windpipe through the cut to let air into the lungs.

How can I help someone who is choking?

The following first aid is general advice. It is not meant to replace the proper training and practice necessary to handle such emergencies. Basic life-saving CPR classes are available from organizations such as local hospitals or the Red Cross in most communities.

Treatment for an adult who is conscious

Treatment for an adult who is conscious is called the Heimlich maneuver. Have someone call 911 for emergency help while you start the Heimlich maneuver:

• Lean the person forward slightly and stand behind him or her.
• Make a fist with one hand.
• Put your arms around the person and grasp your fist with your other hand near the top of the stomach, just below the center of the rib cage.
• Make a quick, hard squeezing movement, pushing your fist inward and upward.

If this movement doesn't dislodge the object, repeat it several times. Once the airway is cleared, begin CPR if needed.

Treatment for an adult who is unconscious

If the person is unconscious and has stopped breathing, call 911 and start CPR (cardiopulmonary resuscitation) as taught in your community. Between each set of 30 chest compressions and 2 rescue breaths, open the person's mouth to see if you can see the object. Try to remove it only if you can see it.

Repeat these 3 steps (30 chest compressions, look for object, 2 rescue breaths) until one of them is successful in dislodging the food or until emergency help arrives.

How long will the effects last?

The choking sensation will last as long as the food or object remains stuck. After a minute or so of being unable to breathe or cough, the person may faint.

After the object is removed, the throat may be sore if it was scratched by the obstruction.

What can be done to help prevent choking?

Take these steps to prevent choking:

• Cut food into small pieces. Do not try to swallow large pieces of food.
• Be careful to chew foods thoroughly, especially when you are drinking alcoholic beverages.
• Avoid drinking too much alcohol before or during meals. Alcohol dulls the nerves that help swallowing.
• Don't eat when you are talking, laughing, walking, running, or playing. This reduces the chance that you will inhale a piece of food that can get stuck in your throat.
• Make sure dentures fit properly. Loose-fitting dentures may make it hard to chew and to feel objects in your mouth.