preventing choking
TRANSCRIPT
-
7/30/2019 Preventing Choking
1/18
Preventing Choking
in Children
Presented by:
Caitlin Kaeppler and Matt Schmieder
-
7/30/2019 Preventing Choking
2/18
-
7/30/2019 Preventing Choking
3/18
Epidemiology
29.9 episodes of non-fatal choking per 100,000children, aged 14 and younger
140.4 per 100,000 of infants (1/3 of incidents)
77.1% of episodes occurred in children < 3 yr
59.5% non-fatal choking episodes related to food
19% related to candy or gum
-
7/30/2019 Preventing Choking
4/18
Epidemiology
Choking on food results in death of 1 child every5 days in US
66 77 children under ten die of food-relatedchoking events, per year, in US
>10,000 ED visits annually for children < 14 yrs
Hot dogs represent the cause of 17% of food-related asphyxiations (children
-
7/30/2019 Preventing Choking
5/18
Contributing Factors
Mastication development and coordination lagsbehind dentition and swallowing ability
Smaller diameter hypopharynx = greater risk forblockage
Mucus/secretions collect around blockage
forming a seal Forced expiration and cough less powerful, less
effective in children
-
7/30/2019 Preventing Choking
6/18
Contributing Factors
Children < 4 years
Underlying chewing/swallowing dysfunction
Impaired food grinding during phase betweenincisor eruption and molar eruption
Distractibility
Extraneous activity, while eating; running,talking, laughing, etc.
High risk behaviors throwing food up andcatching it in mouth
-
7/30/2019 Preventing Choking
7/18
High Risk Food Characteristics
Cylindrical or round or ovoid
Airway-sized
Compressible
Capable of forming a pliable seal, such as peanutbutter
-
7/30/2019 Preventing Choking
8/18
High Risk Foods Hot dogs Nuts and seeds
Meat and cheese chunks Whole grapes Hard or sticky candy Popcorn
Peanut butter Raw vegetables Chewing gum Marshmallows
-
7/30/2019 Preventing Choking
9/18
Prevention Policies AAP Recommendations from Policy Statement:
Surveillance
Extension of NEISS-AIP to food-related choking events Food and Drug Administration in cooperation with CPSCfor oversight
Cautionary food labeling Mandatory system for application of appropriate
warnings Sweden as a model of age-based labeling of food products
Recalls, as needed Gel candy containing Konjac
Public education: Food-related choking-preventioncampaign
-
7/30/2019 Preventing Choking
10/18
Anticipatory Guidance
Always supervise young children while eating
Do not allow children < 3 years to eat small,round, hard, or high-risk foods
Cut foods into small pieces, (< 0.5 inches)
Provide foods that do not need to be chewed,
until appropriate dentition for chewing develops No eating/sucking candy while playing or lying
down; sit at table or high chair
-
7/30/2019 Preventing Choking
11/18
Choking on non-food objects
-
7/30/2019 Preventing Choking
12/18
Epidemiology
In 2001, 17,537 children ages 14 years oryounger were treated in U.S. EDs for choking
60% associated with food item
31% associated with nonfood objects
9% were not recorded
From 1972-1992: 449 deaths from aspiratednonfood foreign bodies in children 14 andyounger
-
7/30/2019 Preventing Choking
13/18
Common objects
Coins
Balloons- especially deflated or broken pieces
Marbles
Button batteries
Pen or marker caps
Small jewelry Magnets
-
7/30/2019 Preventing Choking
14/18
Child Safety Protection Act
Requires choking-hazard warning labels onpackaging for small balls, balloons, marbles, and
other toys
Defines age groups for toys
Bans any toy intended for children 3 and
younger which may pose a risk Small-parts test fixture
Since 2008, choking-hazard warnings arerequired on ads, websites, catalogs, etc.
-
7/30/2019 Preventing Choking
15/18
How small is too small?
-
7/30/2019 Preventing Choking
16/18
Gaps in prevention
Studies showing that the criteria for toys shouldbe stricter
CPSC does not conduct premarket testing
Poor consumer response to product recalls
-
7/30/2019 Preventing Choking
17/18
Prevention strategies
Educating parents, child care providers, andpreschool teachers
Caregiver vigilance
Cpsc.gov
Clear product labeling describing hazards
Basic CPR and choking resuscitation training
-
7/30/2019 Preventing Choking
18/18
References David Walner and Julie Wei. Preventing choking in children: Many factors
increase risk of mechanical airway obstruction due to inhalation oringestion of foreign bodies.AAP News 2011;32;16
David Ma. Reduce deadly choking risks in children.AAP News 2010;31;26 Policy Statement-Prevention of Choking Among Children. Committee on
injury, violence, and poison prevention.Pediatrics; originally publishedonline February 22, 2010Prevention of Choking Among Children.Committee on Injury, Violence, and Poison Prevention. Pediatrics. Vol.125 No. 3 March 1, 2010. pp. 601-607.
Choking Prevention. HealthyChildren.org.http://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspx
Choking Prevention Tips. Safe Kids USA. http://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.html
Airway Foreign Bodies in Children. UpToDate.com. Jan 21, 2013.
http://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspxhttp://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspxhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.safekids.org/safety-basics/safety-resources-by-risk-area/choking-suffocation-and-strangulation/choking-prevention-safety.htmlhttp://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspxhttp://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspxhttp://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspxhttp://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspxhttp://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspxhttp://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspxhttp://www.healthychildren.org/English/health-issues/injuries-emergencies/pages/Choking-Prevention.aspx