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Management of Airway Obstruction

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Cardiopulmonary Resuscitation

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Death by acute airway obstruction has been recognized for centuries. George Washington is thought to have died in 1799 from upper airway obstruction p caused by acute bacterial epiglottitis (1). Although letting of more than 2 L of blood out of their patient, President Washington’s physicians apparently discussed performing a tracheotomy, a procedure that had been described in detail only the year before. However, they did not have the courage to carry out the new procedure on the retired president of the United States. Dr. R. K. Haugen wrote a now-classic description of the problem of choking in 1963 (2). He described what he termed the café coronary:

A middle-aged or elderly person, at a fashionable restaurant, is partaking of filet mignon, or perhaps broiled lobster or prime rib of beef. At the same time, he is conversing with companions at dinner. Suddenly, he ceases to eat and talk. The dinner companions are perplexed but not alarmed for there is no indication of distress. Then, the person suddenly collapses at the table.

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References

  1. Morens DM. Death of a president. N Engl J Med 1999; 341:1845–1849.

    Article  PubMed  CAS  Google Scholar 

  2. Haugen RK. The café coronary: sudden death in restaurants. JAMA 1963; 186:142–143.

    PubMed  CAS  Google Scholar 

  3. Centers for Disease Control. 1999 Mortality for Choking (ICD-10 Codes W79-W80) in the United States. http://wonder.cdc.gov. 2002. Centers Disease Control and Prevention WONDER Search Tool. Accessed: 1-3-2003.

  4. Nonfatal choking-related episodes among children—United States, 2001. MMWR Morb Mortal Wkly Rep 2002; 51:945–948.

    Google Scholar 

  5. American Academy of Pediatrics. Toddler’s diet: Understanding your toddler’s diet. http://www.medem.com/search/article_display.cfm?path=n:&mstr=/ZZZ61B4NH4C.html&soc=AAP&srch_typ=NAV_SERCH. 2000. American Academy of Pediatrics. Accessed: 12-16-2002.

  6. Rimell FL, Thome A, Jr., Stool S, et al. Characteristics of objects that cause choking in children. JAMA 1995; 274:1763–1766.

    Article  PubMed  CAS  Google Scholar 

  7. Tarrago SB. Prevention of choking, strangulation, and suffocation in childhood. WMJ 2000; 99:43–6, 42.

    PubMed  CAS  Google Scholar 

  8. Ryan CA, Yacoub W, Paton T, Avard D. Childhood deaths from toy balloons. Am J Dis Child 1990; 144:1221–1224.

    PubMed  CAS  Google Scholar 

  9. Bhana BD, Gunaselvam JG, Dada MA. Mechanical airway obstruction caused by accidental aspiration of part of a ballpoint pen. Am J Forensic Med Pathol 2000; 21:362–365.

    Article  PubMed  CAS  Google Scholar 

  10. Lundberg GD. Changing physician behavior in ordering diagnostic tests. JAMA 1998; 280:2036.

    Article  PubMed  CAS  Google Scholar 

  11. Heimlich HJ. Pop goes the café coronary. Emerg Med 1974; 6:154–155.

    Google Scholar 

  12. Heimlich HJ. A life-saving maneuver to prevent food-choking. JAMA 1975; 234:398–401.

    Article  PubMed  CAS  Google Scholar 

  13. Sternbach G, Kiskaddon RT. Henry Heimlich: a life-saving maneuver for food choking. J Emerg Med 1985; 3:143–148.

    Article  PubMed  CAS  Google Scholar 

  14. Heimlich HJ. Heimlich defends his maneuver. N Engl J Med 1978; 299:1415.

    PubMed  CAS  Google Scholar 

  15. Heimlich HJ. Back blows or death blows. Emerg Med Serv 1979; 8:88–95.

    Google Scholar 

  16. Ingalls TH. Death comes to dinner: the hazards of high living. Arch Environ Health 1973; 27:342–343.

    PubMed  CAS  Google Scholar 

  17. Ingalls TH. Heimlich versus a slap on the back. N Engl J Med 1979; 300:990.

    Article  PubMed  CAS  Google Scholar 

  18. Westfal R. Foreign body airway obstruction: when the Heimlich maneuver fails. Am J Emerg Med; 1997; 15:103–105.

    Article  PubMed  CAS  Google Scholar 

  19. Brown L, Sherwin T, Perez JE, Perez DU. Heliox as a temporizing measure for pediatric foreign body aspiration. Acad Emerg Med 2002; 9:346–347.

    Article  PubMed  Google Scholar 

  20. Langhelle A, Sunde K, Wik L, Steen PA. Airway pressure with chest compressions versus Heimlich manoeuvre in recently dead adults with complete airway obstruction. Resuscitation 2000; 44:105–108.

    Article  PubMed  CAS  Google Scholar 

  21. Heimlich HJ, Spletzer EG. Chest compressions yielded higher airway pressures than Heimlich maneuvers when the airway was obstructed. Resuscitation 2001; 48:185–187.

    Article  PubMed  CAS  Google Scholar 

  22. Langhelle A, Wik L, Sunde K. Correspondence. Resuscitation 2001; 48:186–187.

    Article  Google Scholar 

  23. Ruben H, MacNaughton FI. The treatment of food-choking. Practitioner 1978; 221:725–729.

    PubMed  CAS  Google Scholar 

  24. Day RL, Crelin ES, DuBois AB. Choking: the Heimlich abdominal thrust vs back blows: an approach to measurement of inertial and aerodynamic forces. Pediatrics 1982; 70:113–119.

    PubMed  CAS  Google Scholar 

  25. Heimlich HJ, Hoffmann KA, Canestri FR. Food-choking and drowning deaths prevented by external subdiaphragmatic compression: physiological basis. Ann Thorac Surg 1975; 20:188–195.

    Article  PubMed  CAS  Google Scholar 

  26. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 3: adult basic life support. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Circulation 2000; 102:I22–I59.

    Google Scholar 

  27. Heimlich HJ. Self-application of the Heimlich maneuver. N Engl J Med 1988; 318:714–715.

    Article  PubMed  CAS  Google Scholar 

  28. Handley AJ, Monsieurs KG, Bossaert LL. European Resuscitation Council Guidelines 2000 for Adult Basic Life Support. A statement from the Basic Life Support and Automated External Defibrillation Working Group and approved by the Executive Committee of the European Resuscitation Council. Resuscitation 2001; 48:199–205.

    Article  PubMed  CAS  Google Scholar 

  29. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 9: pediatric basic life support. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Circulation 2000; 102:I253–I290.

    Google Scholar 

  30. Hoffman JR. Treatment of foreign body obstruction of the upper airway. West J Med 1982; 11–22.

    Google Scholar 

  31. Ayerdi J, Gupta SK, Sampson LN, Deshmukh N. Acute abdominal aortic thrombosis following the Heimlich maneuver. Cardiovasc Surg 2002; 10:154–156.

    Article  PubMed  Google Scholar 

  32. Bintz M, Cogbill TH. Gastric rupture after the Heimlich maneuver. J Trauma 1996; 40:159–160.

    Article  PubMed  CAS  Google Scholar 

  33. Valero V. Mesenteric laceration complicating a Heimlich maneuver. Ann Emerg Med 1986; 15:105–106.

    Article  PubMed  CAS  Google Scholar 

  34. Wolf DA. Heimlich trauma: a violent maneuver. Am J Forensic Med Pathol 2001; 22:65–67.

    Article  PubMed  CAS  Google Scholar 

  35. Hartrey R, Bingham RM. Pharyngeal trauma as a result of blind finger sweeps in the choking child. J Accid Emerg Med 1995; 12:52–54.

    PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Good Samaritan Hospital, Cincinnati, OH

    Michael R. Sayre MD

Authors
  1. Michael R. Sayre MD
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Editor information

Editors and Affiliations

  1. Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, VA

    Joseph P. Ornato MD, FACP, FACC, FACEP  & Mary Ann Peberdy MD, FACC  & 

  2. Department of Internal Medicine (Cardiology), Virginia Commonwealth University Health System, Richmond, VA

    Joseph P. Ornato MD, FACP, FACC, FACEP  & Mary Ann Peberdy MD, FACC  & 

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© 2005 Humana Press Inc., Totowa, NJ

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Sayre, M.R. (2005). Management of Airway Obstruction. In: Ornato, J.P., Peberdy, M.A. (eds) Cardiopulmonary Resuscitation. Contemporary Cardiology. Humana Press. https://doi.org/10.1385/1-59259-814-5:111

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  • DOI: https://doi.org/10.1385/1-59259-814-5:111

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-283-4

  • Online ISBN: 978-1-59259-814-4

  • eBook Packages: MedicineMedicine (R0)

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