September 2017

Choking on food or small objects

This important advice comes from Disability SA Bulletin 104 provided by Disability SA, the South Australian Department for Communities and Social Inclusion.

The Quality Agency is reprinting the article as the advice is also useful for older people and those with dementia.

Choking on food or a small object can occur at any age. Children and adults with disability might be at higher risk of choking.

Choking occurs when the airway is partly or completely blocked by a piece of food or a foreign body (for example, a small object).

Common causes of choking

  • Eating or drinking too quickly.
  • Swallowing food before it has been sufficiently chewed.
  • Swallowing small bones or objects.
  • Inhaling small objects.

Generally, any object smaller than a table tennis ball can be a choking hazard.

Choking hazards include:

  • food items like lollies, raw apples, pieces of meat (including chicken and fish), nuts, raw carrots, uncooked peas, seeds (including popcorn kernels), grapes, fruit pips and stones, hot dogs and sausages
  • household items like latex gloves, coins, small batteries, the tops off pens and markers, bottle caps, plastic tabs from protective coverings on containers, paper clips, safety pins, beads and other jewellery
  • toys and toy parts like plastic shapes, marbles, the eyes of stuffed toys and balloons (either uninflated or broken pieces)
  • garden objects like pebbles and bark.

Choking on non-food objects

Young children and some adults with disability may place small objects into their mouth as a means of exploring the world around them. Any small object that a child or adult with disability has access to can be a potential choking risk.

How to prevent choking on non-food objects

  • Identify specific habits or behaviours that may place a child or adult with disability at risk of injury (for example, oral exploration).
  • Identify hazards (as listed above) in the environment around the child or adult with disability that may place them at risk of injury.
  • Ensure small objects that could be inhaled (get into someone’s windpipe) or swallowed are kept out of reach, securely stored and safely disposed of.
  • Use items/toys that are solid and sturdy, avoiding items/toys with small parts, breakable parts or brittle surfaces. Check items/toys for things like exposed stuffing, loose screws and buttons.
  • Ensure people who may be at risk of choking are appropriately supervised and that information about their care needs are documented and shared with those supporting them.


Choking on food items

Children and adults with disability may need support from others to access food and drinks, or alternative methods of nourishment such as enteral (non-oral) nutrition. They may also have swallowing issues that can affect safety at mealtimes or may need to rely on support staff to assist them to eat and drink.

The risk of choking or aspiration (food or drink going into the airway) may be increased if incorrect food or fluid consistencies are provided or if inappropriate support strategies are used.

How to prevent choking on food items

  • Ensure recommendations made by health care professionals regarding mealtime management requirements of a child or adult with disability are clearly documented, available and followed by those supporting them.
  • If the person has a modified diet or fluid consistency, ensure the specific food inclusions and exclusions for that texture (such as, soft/cut up, modified soft, minced moist, smooth puree) are adhered to.
  • Ensure the person has the appropriate supervision when eating and drinking, as documented in their mealtime safety recommendations.

Some high choking risk foods include:

  • foods that can break off into small hard pieces such as corn chips
  • hard fruit and vegetables like carrots and apples
  • whole grapes
  • sausages, frankfurts and other meats with coarse outer skins
  • stringy meats such as chicken and steak
  • popcorn, nuts, hard lollies or other similar foods.


Choking is a medical emergency

  • Check if the person is still able to breathe or cough.
  • If the person is able to cough, encourage coughing and send for help.
  • If the person is unable to cough, call 000 immediately and follow the instructions of the ambulance service operator.

Resources

Choking - HealthDirect

Choking on food and other objects - Child and Youth Health

Prevention of choking, suffocation and strangulation in young children - Kidsafe SA Inc [PDF 394 KB]

Choking - emedicinehealth

Mealtime Management Framework - Government of South Australia [PDF 1.1 MB]

Choking Flowchart (Management of Foreign Body Airway Obstruction) - Australian Resuscitation Council

With thanks again to Disability SA and the South Australian Department for Communities and Social Inclusion for allowing us to reprint this article from the Disability SA Bulletin 104.