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96-462: Choking , also known as foreign body airway obstruction ( FBAO ), is a phenomenon that occurs when breathing is impeded by a blockage inside of the respiratory tract . An obstruction that prevents oxygen from entering the lungs results in oxygen deprivation . Although oxygen stored in the blood and lungs can keep a person alive for several minutes after breathing stops, choking often leads to death. Around 4,500 to 5,000 choking-related deaths occur in
192-523: A code point in Unicode at U+2300 ⌀ DIAMETER SIGN , in the Miscellaneous Technical set. It should not be confused with several other characters (such as U+00D8 Ø LATIN CAPITAL LETTER O WITH STROKE or U+2205 ∅ EMPTY SET ) that resemble it but have unrelated meanings. It has the compose sequence Compose d i . The diameter of
288-456: A curve of constant width such as the Reuleaux triangle , the width and diameter are the same because all such pairs of parallel tangent lines have the same distance. For an ellipse , the standard terminology is different. A diameter of an ellipse is any chord passing through the centre of the ellipse. For example, conjugate diameters have the property that a tangent line to the ellipse at
384-450: A foreign body blocks the airway. This obstruction can be located in the pharynx , the larynx , trachea , or lower respiratory tract. The blockage can be either partial (insufficient air passes through to the lungs) or complete (complete blockage of airflow). Foods that are small, round, or hard pose a high risk of choking. Examples include hard candy, chunks of cheese or hot dogs, nuts, grapes, marshmallows, and popcorn. Among children,
480-430: A try to extract it, usually by using a finger sweeping (hopefully from the mouth). Normally, the object would be a food bolus (and not the epiglottis, a cartilaginous flap of the throat). It is also possible to try to extract it when it is deeper and not visible, always carefully: using the fingers to take it, or lifting the victim's chin to form a straight way to the throat while the victim is face up (face down in case of
576-427: A cardiac arrest at any moment, due to several possible causes. So it is convenient to ask around for a defibrillator (AED device), for trying a defibrillation on a victim that remains in cardiac arrest after having extracted the stuck object (if it has been extracted, and only after that). Those defibrillators are easy to use, as they emit their instructions with voice messages. It is crucial to avoid blindingly sweeping
672-430: A cardiac arrest, it will require to perform a normal cardiopulmonary resuscitation (CPR), as described below, but only alternating the 30 compressions and the two rescue breaths. Emergency medical services must be called, if this has not already been done. It can be also convenient that any rescuer asks for a defibrillator around (an AED, as those devices are very common today), just in case it can be necessary to treat
768-421: A delay in diagnosis because there may not be a known history of a foreign body entering the airway. Choking on food is only one type of airway obstruction ; others include blockage due to tumors, swelling and inflammation of the airway tissues (from organic foreign bodies or another reason), and compression of the laryngopharynx , larynx , or vertebrate trachea in strangulation . Foreign bodies can also enter
864-407: A finger sweep unless an object can be clearly seen in the victim's mouth to prevent driving the obstruction deeper into the victim's airway. Other protocols suggest that if the patient is conscious they will be able to remove the foreign object themselves, or if they are unconscious, the rescuer should place them in the recovery position to allow the drainage of fluids out of the mouth instead of down
960-411: A left and a right main bronchus . The bronchi branch off into smaller sections inside the lungs, called bronchioles . These bronchioles give rise to the air sacs in the lungs called the alveoli . The lungs are the largest organs in the lower respiratory tract. The lungs are suspended within the pleural cavity of the thorax. The pleurae are two thin membranes, one cell layer thick, which surround
1056-437: A low resistance pathway for airflow. It provides a major defense role in its filtering abilities. The respiratory zone includes the respiratory bronchioles, alveolar ducts, and alveoli, and is the site of oxygen and carbon dioxide exchange with the blood. The respiratory bronchioles and the alveolar ducts are responsible for 10% of the gas exchange. The alveoli are responsible for the other 90%. The respiratory zone represents
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#17328585270361152-425: A more general definition that is valid for any kind of n {\displaystyle n} -dimensional (convex or non-convex) object, such as a hypercube or a set of scattered points. The diameter or metric diameter of a subset of a metric space is the least upper bound of the set of all distances between pairs of points in the subset. Explicitly, if S {\displaystyle S}
1248-402: A process called mucociliary clearance , they prevent mucus accumulation in the lungs. Macrophages in the alveoli are part of the immune system which engulf and digest any inhaled harmful agents. Hair in the nostrils plays a protective role, trapping particulate matter such as dust. These hairs, called vibrissae, are thicker than body hair and effectively block larger particles from entering
1344-432: A surface. That surface should be firm enough (it is recommended placing a layer of something on the floor and laying the victim above). A rescuer can then ask for any of the known anti-choking devices that is available, and use it on the unconscious victim. After that, the obstruction would be dislodged, but it could remain into the mouth, which needs a manual removal. If the unconscious victim cannot breath then, or stays in
1440-459: A vacuum by direct pressure against the patient's face. However, these products have not been well-studied in clinical trials or pre-hospital settings and literature is relatively sparse given the challenges in trial design. A 2020 systematic review of the effectiveness of the three devices listed discovered "a more detailed review of the studies demonstrated a very low certainty of evidence for its use", and concluded that "there are many weaknesses in
1536-462: Is 480 million. When the diaphragm contracts, a negative pressure is generated in the thorax and air rushes in to fill the cavity. When that happens, these sacs fill with air, making the lung expand. The alveoli are rich with capillaries, called alveolar capillaries. Here the red blood cells absorb oxygen from the air and then carry it back in the form of oxyhaemaglobin, to nourish the cells. The red blood cells also carry carbon dioxide (CO 2 ) away from
1632-436: Is a common lower respiratory disease that can be caused by exposure to harmful chemicals, or prolonged use of tobacco. This disease is chronic and progressive, the damage to the lungs is irreversible and eventually fatal. COPD destroys the alveoli, and lung tissue which makes breathing very difficult, causing shortness of breath , hyperventilation , and raised chest. The decreased number of alveoli causes loss of oxygen supply to
1728-530: Is also called the voice box and has the associated cartilage that produces sound. The tract consists of the nasal cavity and paranasal sinuses , the pharynx ( nasopharynx , oropharynx and laryngopharynx ) and sometimes includes the larynx. The lower respiratory tract or lower airway is derived from the developing foregut and consists of the trachea , bronchi (primary, secondary and tertiary), bronchioles (including terminal and respiratory), and lungs (including alveoli ). It also sometimes includes
1824-409: Is convenient that one hand supports the victim's chest. Then the back blows are performed by delivering forceful slaps with the heel of the hand on the victim's back, between the shoulder blades. The back slaps push behind the blockage to expel the foreign object out. In some cases, the physical vibration of the action may cause enough movement to clear the airway. Abdominal thrusts are performed with
1920-405: Is coughing, wheezing, and diminished breath sounds, however, a 10-year review showed that this grouping of symptoms was present together in only about 60% of patients. Loss of consciousness may occur if breathing is not restored. In the setting of lower airway aspiration, patients may develop pneumonia like symptoms such as fever, chest pain, foul smelling sputum, or blood in sputum (hemoptysis). In
2016-532: Is deadly if not treated. Some of these cancers have environmental causes such as smoking. When a tobacco product is inhaled, the smoke paralyzes the cilia, causing mucus to enter the lungs. Frequent smoking, over time, causes the cilia hairs to die and can no longer filter mucus. Tar from the smoke inhaled enters the lungs, turning the pink-coloured lungs black. The accumulation of this tar could eventually lead to lung cancer , or chronic obstructive pulmonary disease . Chronic obstructive pulmonary disease (COPD)
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#17328585270362112-414: Is divided into the upper airways and lower airways . The upper airways or upper respiratory tract includes the nose and nasal passages, paranasal sinuses , the pharynx , and the portion of the larynx above the vocal folds (cords). The lower airways or lower respiratory tract includes the portion of the larynx below the vocal folds, trachea , bronchi and bronchioles . The lungs can be included in
2208-427: Is interspersed with goblet cells that secrete a protective mucus . This helps to filter waste, which is eventually either swallowed into the highly acidic stomach environment or expelled via spitting. The epithelium lining the respiratory tract is covered in small hairs called cilia . These beat rhythmically out from the lungs, moving secreted mucus foreign particles toward the laryngopharynx upwards and outwards, in
2304-408: Is quite similar to any other CPR, but with some modifications: In a first step, a series of 30 chest compressions are applied on the lower half of the sternum (the bone that is along the middle of the chest from the neck to the belly) at an approximate rhythm of nearly 2 per second. After that series, the rescuer looks for the obstructing object and, if it is already visible, the rescuer makes
2400-455: Is seen in around 90% of choking episodes. Initial episodes typically last seconds to several minutes, but can be followed by symptom improvement that can be mistaken as resolution. Initial respiratory symptoms can include involuntary cough, gurgling, gagging, shortness of breath, labored breathing, or wheezing. Children often present with excessive drooling and stridor (high pitched breathing sounds). Classic triad of choking symptoms in children
2496-446: Is the same as the diameter of its convex hull . In medical terminology concerning a lesion or in geology concerning a rock, the diameter of an object is the least upper bound of the set of all distances between pairs of points in the object. In differential geometry , the diameter is an important global Riemannian invariant . In planar geometry , a diameter of a conic section is typically defined as any chord which passes through
2592-449: Is the subset and if ρ {\displaystyle \rho } is the metric , the diameter is diam ( S ) = sup x , y ∈ S ρ ( x , y ) . {\displaystyle \operatorname {diam} (S)=\sup _{x,y\in S}\rho (x,y).} If the metric ρ {\displaystyle \rho }
2688-400: Is viewed here as having codomain R {\displaystyle \mathbb {R} } (the set of all real numbers ), this implies that the diameter of the empty set (the case S = ∅ {\displaystyle S=\varnothing } ) equals − ∞ {\displaystyle -\infty } ( negative infinity ). Some authors prefer to treat
2784-413: The bronchi and bronchioles , which it completely encircles. Instead of hard cartilage, the bronchi and bronchioles are composed of elastic tissue. The lungs are made up of thirteen different kinds of cells, eleven types of epithelial cell and two types of mesenchymal cell. The epithelial cells form the lining of the tracheal, and bronchial tubes, while the mesenchymal cells line the lungs. Most of
2880-478: The conic's centre ; such diameters are not necessarily of uniform length, except in the case of the circle, which has eccentricity e = 0. {\displaystyle e=0.} The symbol or variable for diameter, ⌀ , is sometimes used in technical drawings or specifications as a prefix or suffix for a number (e.g. "⌀ 55 mm"), indicating that it represents diameter. Photographic filter thread sizes are often denoted in this way. The symbol has
2976-450: The mouse has up to 13 generations. Proximal divisions (those closest to the top of the tree, such as the bronchi) mainly function to transmit air to the lower airways. Later divisions including the respiratory bronchiole, alveolar ducts, and alveoli, are specialized for gas exchange . The trachea is the largest tube in the respiratory tract and consists of tracheal rings of hyaline cartilage . It branches off into two bronchial tubes,
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3072-431: The nose to the nasal cavity , where a layer of nasal mucosa acts as a filter and traps pollutants and other harmful substances found in the air. Next, air moves into the pharynx , a passage that contains the intersection between the oesophagus and the larynx . The opening of the larynx has a special flap of cartilage, the epiglottis , that opens to allow air to pass through but closes to prevent food from moving into
3168-405: The pleurae – a two-layered protective barrier. The inner visceral pleura covers the surface of the lungs, and the outer parietal pleura is attached to the inner surface of the thoracic cavity. The pleurae enclose a cavity called the pleural cavity that contains pleural fluid . This fluid is used to decrease the amount of friction that lungs experience during breathing. The respiratory tract
3264-409: The respiratory center in the medulla oblongata , the motor neurons controlling the muscles also receive tonic innervation that sets a baseline level of stiffness and size. The diaphragm is the primary muscle that allows for lung expansion and contraction. Smaller muscles between the ribs, the external intercostals , assist with this process. The epithelial lining of the upper respiratory tract
3360-440: The thoracic cavity , are protected from physical damage by the rib cage . At the base of the lungs is a sheet of skeletal muscle called the diaphragm . The diaphragm separates the lungs from the stomach and intestines . The diaphragm is also the main muscle of respiration involved in breathing , and is controlled by the sympathetic nervous system . The lungs are encased in a serous membrane that folds in on itself to form
3456-453: The victims that lay on the bed but are unable to sit down , and for the victims that lay on the floor but are unable to sit down . In scenarios when the first aid procedures are not resolving the choking, it is necessary to call to emergency medical services , but administration of first aid should be continued until they arrive. Choking can change the colour in the victim's faces due to lack of oxygen. If they lose consciousness and fall to
3552-430: The 16th through the 23rd division of the respiratory tract. From the bronchi, the dividing tubes become progressively smaller with an estimated 20 to 23 divisions before ending at an alveolus. The upper respiratory tract can refer to the parts of the respiratory system lying above the vocal folds , or above the cricoid cartilage . The larynx is sometimes included in both the upper and lower airways. The larynx
3648-554: The American Red Cross and the Mayo Clinic, recommend the use of back blows (back slaps) to aid a choking victim. This technique is performed by bending the choking victim forward as much as possible, even trying to place their head lower than the chest, to avoid the blows driving the object deeper into the person's throat (a rare complication, but possible). The bending is in the back, while the neck should not be excessively bent. It
3744-466: The CPR procedure must pass to the next step and continue until the victims can breathe by themselves or emergency medical services arrive. In the next step of the CPR, the rescuer applies a rescue breath , pinching the victim's nose and puffing air inside of the mouth. Rescue breaths would usually fail while the obstructing object is blocking the entrance of air. Anyway, it is recommended, additionally, tilting
3840-674: The Heimlich maneuver. In advanced airway management , complex clinical methods are used. Basic treatment of choking includes several non-invasive techniques to help remove foreign bodies from the airways. For a conscious choking victim, most institutions such as the American Heart Association, the American Red Cross and the NHS, recommend the same general protocol of first-aid: encouraging the victim to cough, followed by hard back slaps (as described forward). If these attempts are not effective,
3936-541: The LifeVac for its effectiveness in clearing the airway passages. The scientific analyses of the LifeVac revealed a dislodgement rate of 94% during the first attempt, 99.6% on the second attempt, and a 100% success rate on the third attempt. There has so far been no known side effects due to the LifeVac device according to these studies. According to the findings, the evaluation on PubMed records from September 2019 through March 2023 which identified nearly 4,000 documents relating to
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4032-499: The United States every year. Deaths from choking most often occur in the very young (children under three years old) and in the elderly (adults over 75 years). Foods that can adapt their shape to that of the pharynx (such as bananas, marshmallows, or gelatinous candies) are more dangerous. Various forms of specific first aid are used to address and resolve choking. Choking is the fourth leading cause of unintentional injury death in
4128-443: The United States. Many episodes go unreported because they are brief and resolve without needing medical attention. Of the reported events, 80% occur in people under 15 years of age, and 20% occur in people older than 15 years of age. Worldwide, choking on a foreign object resulted in 162,000 deaths (2.5 per 100,000) in 2013, compared with 140,000 deaths (2.9 per 100,000) in 1990. Choking victims may present very subtly, especially in
4224-565: The airway unless there is direct visualization of the airway – in fact, these procedures are advised only to be performed in more controlled environments such as an operating room. In unconscious choking victims, the American Medical Association has previously advocated sweeping the fingers across the back of the throat to attempt to dislodge airway obstructions. Many modern protocols suggest other treatment modalities are superior. Red Cross procedures also advise rescuers not to perform
4320-493: The airway. From the larynx , air moves into the trachea and down to the intersection known as the carina that branches to form the right and left primary (main) bronchi . Each of these bronchi branches into a secondary (lobar) bronchus that branches into tertiary (segmental) bronchi , that branch into smaller airways called bronchioles that eventually connect with tiny specialized structures called alveoli that function in gas exchange . The lungs which are located in
4416-584: The available data and few unbiased trials that test the effectiveness of anti-choking suction devices resulting in insufficient evidence to support or discourage their use. Practitioners should continue to adhere to guidelines authored by local resuscitation authorities which align with ILCOR recommendations." Some anti-choking devices like Act Fast Anti Choking Trainer are used as training devices by healthcare providers as well as schools in CPR training courses. A choking victim who becomes unconscious must be gently caught before falling and placed lying face-up on
4512-405: The babies' procedures require the normal first aid techniques against choking. Respiratory tract The respiratory tract is the subdivision of the respiratory system involved with the process of conducting air to the alveoli for the purposes of gas exchange in mammals . The respiratory tract is lined with respiratory epithelium as respiratory mucosa. Air is breathed in through
4608-423: The bronchial tubes; as a result, the air passage will swell up, or close up completely. In general, air is inhaled through the nose . It can be inhaled through the mouth if it is not possible to breathe through the nose. However, chronic mouth breathing can cause a dry mouth and lead to infections. Diameter In geometry , a diameter of a circle is any straight line segment that passes through
4704-452: The bronchioles. The same goes for goblet cells, although there are scattered ones in the first bronchioles. Cartilage is present until the small bronchi . In the trachea, they are C-shaped rings of hyaline cartilage , whereas in the bronchi the cartilage takes the form of interspersed plates. Smooth muscle starts in the trachea, where it joins the C-shaped rings of cartilage. It continues down
4800-404: The case of long term foreign body aspiration, patients may present with signs of lobar pneumonia or pleural effusion. The time a choking victim is still alive without brain damage can vary, but typically brain damage can occur when the patient remains without air for approximately three minutes (it is variable). Death can occur if breathing is not restored in six to ten minutes (varies depending on
4896-474: The cells in the form of carbaminohemoglobin and release it into the alveoli through the alveolar capillaries. When the diaphragm relaxes, a positive pressure is generated in the thorax and air rushes out of the alveoli expelling the carbon dioxide. The respiratory tract is covered in epithelium , which varies down the tract. There are glands and mucus produced by goblet cells in parts, as well as smooth muscle , elastin or cartilage . The epithelium from
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#17328585270364992-401: The centre of the circle and whose endpoints lie on the circle. It can also be defined as the longest chord of the circle. Both definitions are also valid for the diameter of a sphere . In more modern usage, the length d {\displaystyle d} of a diameter is also called the diameter. In this sense one speaks of the diameter rather than a diameter (which refers to
5088-414: The empty set as a special case, assigning it a diameter of 0 , {\displaystyle 0,} which corresponds to taking the codomain of ρ {\displaystyle \rho } to be the set of nonnegative reals. For any solid object or set of scattered points in n {\displaystyle n} -dimensional Euclidean space , the diameter of the object or set
5184-636: The endpoint of one diameter is parallel to the conjugate diameter. The longest diameter is called the major axis . The word "diameter" is derived from Ancient Greek : διάμετρος ( diametros ), "diameter of a circle", from διά ( dia ), "across, through" and μέτρον ( metron ), "measure". It is often abbreviated DIA , dia , d , {\displaystyle {\text{DIA}},{\text{dia}},d,} or ∅ . {\displaystyle \varnothing .} The definitions given above are only valid for circles, spheres and convex shapes. However, they are special cases of
5280-571: The ground, it is recommended to avoid panic and begin the appropriate anti-choking resuscitation for unconscious victims or unconscious babies (under 1 year-old) . Each one of the techniques in the first aid protocol against choking are detailed below: If the choking victim is conscious and can cough, the American Red Cross and the Mayo Clinic recommend encouraging them to stay calm and continue coughing freely. Many associations, including
5376-452: The importance for widespread dissemination of the appropriate anti-choking techniques for these age groups. In fact, it has been shown that increased parental education may decrease choking rates among children. For infants under 1 year-old, the American Heart Association recommends adapted procedures. The size of the children's body is the most important aspect in determining the correct anti-choking technique. So children who are too large for
5472-628: The initial episode, choking can lead to an obstruction of the airway that prompts further diagnostic steps. For choking episodes that require emergent evaluation by a doctor, several tools can be used for diagnosis, each with their advantages and drawbacks. Airway management is used to restore a person's ventilation which consists of severity assessment, procedural planning, and may consist of multiple treatment modalities to restore airway. Treatments will vary based on severity and stage of airway blockage. In basic airway management , treatment generally consists of anti-choking first aid techniques , such as
5568-403: The jejunum, diaphragmatic herniation, among others. When abdominal thrusts cannot be performed on the victim (serious injuries, pregnancy, or belly size that is too large for the rescuer to effectively perform abdominal thrust technique), chest thrusts are advised instead. Chest thrusts are performed with the rescuer embracing the chest of the choking victim from behind. Then, the rescuer closes
5664-422: The larynx. The lower respiratory tract is also called the respiratory tree or tracheobronchial tree , to describe the branching structure of airways supplying air to the lungs, and includes the trachea, bronchi and bronchioles. At each division point or generation , one airway branches into two smaller airways. The human respiratory tree may consist on average of 23 generations, while the respiratory tree of
5760-403: The left of the midline. The right lung has three lobes – upper, middle, and lower (or superior, middle, and inferior), and the left lung has two – upper and lower (or superior and inferior), plus a small tongue-shaped portion of the upper lobe known as the lingula. Each lobe is further divided up into segments called bronchopulmonary segments . Each lung has a costal surface, which is adjacent to
5856-494: The line segment itself), because all diameters of a circle or sphere have the same length, this being twice the radius r . {\displaystyle r.} For a convex shape in the plane , the diameter is defined to be the largest distance that can be formed between two opposite parallel lines tangent to its boundary, and the width is often defined to be the smallest such distance. Both quantities can be calculated efficiently using rotating calipers . For
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#17328585270365952-440: The lower respiratory tract or as separate entity and include the respiratory bronchioles, alveolar ducts , alveolar sacs , and alveoli . The respiratory tract can also be divided into a conducting zone and a respiratory zone , based on the distinction of transporting gases or exchanging them. The conducting zone includes structures outside of the lungs – the nose , pharynx , larynx , and trachea , and structures inside
6048-400: The lower respiratory tract. It is an inflammation of the bronchial tubes. There are two forms of this infection: acute bronchitis, which is treatable and can go away without treatment, or chronic bronchitis, which comes and goes, but will always affect one's lungs. Bronchitis increases the amount of mucus that is natural in your respiratory tract. Chronic bronchitis is common in smokers, because
6144-404: The lungs and an increased accumulation of carbon dioxide. There are two types of COPD: primary and secondary. Primary COPD can be found in younger adults. This type of COPD deteriorates the air sacs, and lung mass. Secondary COPD can be found in older adults who smoke or have smoked and have a history of bronchitis. COPD includes symptoms of emphysema and chronic bronchitis . The bronchi are
6240-438: The lungs and move into the air sacs. This infection quickly develops in the lower part of the lung and fills the lung with fluid, and excess mucus. This causes difficulty in breathing and coughing as the lower respiratory tract tries to get rid of the fluid in the lungs. You can be more prone to developing this infection if you have asthma, flu, heart disease, or cancer Bronchitis is another common infection that takes place in
6336-438: The lungs – the bronchi, bronchioles, and terminal bronchioles. The conduction zone conducts air breathed in that is filtered, warmed, and moistened, into the lungs. It represents the 1st through the 16th division of the respiratory tract. The conducting zone is most of the respiratory tract that conducts gases into and out of the lungs but excludes the respiratory zone that exchanges gases. The conducting zone also functions to offer
6432-425: The lungs. The inner ( visceral pleura ) covers the lungs and the outer ( parietal pleura ) lines the inner surface of the chest wall. This membrane secretes a small amount of fluid, allowing the lungs to move freely within the pleural cavity while expanding and contracting during breathing. The lungs are divided into different lobes. The right lung is larger in size than the left, because of the heart's being situated to
6528-469: The main passages to the right and left lungs. These airways carry oxygen to the bronchioles inside the lungs. Inflammation of the bronchii and bronchioles can cause them to swell up, which could lead to an asthma attack. This results in wheezing , tightness of the chest, and severe difficulty in breathing. There are different types of asthma that affect the functions of the bronchial tubes. Allergies can also set off an allergic reaction, causing swelling of
6624-414: The most common causes of an upper respiratory tract infection, which can cause more serious illness that can develop in the lower respiratory tract. Pneumonia is the most common, and frequent lower respiratory tract infection . This can be either viral, bacterial, or fungal. This infection is very common because pneumonia can be airborne, and when you inhale this infection in the air, the particles enter
6720-511: The most common causes of choking are food, coins, toys, and balloons. In one study, peanuts were the most common object found in the airway of children evaluated for suspected foreign body aspiration . Small, round non-food objects such as balls, marbles, toys, and toy parts are also associated with a high risk of choking death because of the potential to completely block a child's airway. Children younger than age three are especially at risk of choking due to lack of fully developed chewing habits, and
6816-523: The most common infections in the world. The respiratory system is very prone to developing infections in the lungs. Infants and older adults are more likely to develop infections in their lungs because their lungs are not as strong in fighting off these infections. Most of these infections used to be fatal, but with new research and medicine, they are now treatable. With bacterial infections, antibiotics are prescribed, while viral infections are harder to treat but still curable. The common cold , and flu are
6912-428: The nose to the bronchioles is covered in ciliated pseudostratified columnar epithelium , commonly called respiratory epithelium . The cilia beat in one direction, moving mucus towards the throat where it is swallowed. Moving down the bronchioles, the cells get more cuboidal in shape but are still ciliated. Glands are abundant in the upper respiratory tract, but there are fewer lower down and they are absent starting at
7008-453: The obstructing object if it is not visible (a blind extraction), because of the risk to sink it deeper by accident, and because the compressions could move the object outside by themselves (in some cases). Moreover, if any removal is tried and is taking too much time, it may require alternating it with the chest compressions at some moments, without hindering to the extraction. And, whether the object has been found and removed in this step or not,
7104-442: The own dominant hand and grasps it with the other hand. This can produce several kinds of fists, but any of them can be valid if it can be placed on the victim's chest without sinking a knuckle too painfully. Keeping the fist with both hands, the rescuer uses it to press forcefully inwards on the lower half of the chest bone ( sternum ). The pressure is not focused on the very endpoint (named xiphoid process ) to avoid breaking it. When
7200-441: The patient's nose and mouth. The current models of anti-choking devices are quite similar: a direct plunger tool (LifeVac and Willnice) and a vacuum syringe (backward syringe) that also keeps the tongue in place by inserting a tube in the mouth (Dechoker). All three of them have received certification, and they have been reported to be effective in real cases. Other mechanical models are in development, such as Lifewand, which creates
7296-423: The person). However, life can be extended by using cardiopulmonary resuscitation for unconscious victims of choking (see more details further below). The face could turn blue ( cyanosis ) from lack of oxygen if breathing is not restored. Cyanosis may also be seen on the fingertips. In a healthy child or adult, this sign is highly sensitive , but is only observed in 15-20% of choking episodes. Choking occurs when
7392-543: The procedure continues with abdominal thrusts (the Heimlich maneuver) or chest thrusts if the victim cannot receive abdominal pressure (as described forward). If none of these techniques are effective, protocol by various institutions recommend alternating the series of back slaps and series of thrusts (these on the abdomen or chest, depending on the victim), 5 times of each technique and repeat ("five and five"). As of October 22, 2024, The American Red Cross has updated its guidelines to include antichoking devices which highlighted
7488-451: The process of breathing . Unlike the trachea and bronchi , the upper airway is a collapsible, compliant tube. As such, it has to be able to withstand suction pressures generated by the rhythmic expansion of the thoracic cavity that sucks air into the lungs. This is accomplished by the contraction of upper airway muscles during inhalation, such as the genioglossus (tongue) and the hyoid muscles. In addition to rhythmic innervation from
7584-416: The reparatory tract through the chest wall, such as in the setting of a gunshot injury. Recognition and diagnosis of choking primarily involves identification of the signs and symptoms like coughing and wheezing (see Signs and Symptoms). Immediate recognition of the symptoms is important, but based on the short length of some episodes, diagnosis during the first 24 hours only occurs in 50–60% of cases. After
7680-427: The rescuer embracing the belly of the choking victim from behind. Then, the rescuer closes their own dominant hand, grasps it with the other hand, and presses forcefully with them on the area located between the chest and the belly button of the victim, in a direction of in-and-up. This method tries to create enough pressure upwards to expel the object that obstructs the airway. The strength is not focused directly against
7776-411: The respiratory tract exists merely as a piping system for air to travel in the lungs, and alveoli are the only part of the lung that exchanges oxygen and carbon dioxide with the blood . Respiration is the rhythmical process of breathing , in which air is drawn into the alveoli of the lungs via inhalation and subsequently expelled via exhalation . When a human being inhales, air travels down
7872-460: The respiratory tract. They also increase the surface area for particle deposition, improving the nose's ability to filter pathogens. The cough reflex expels all irritants within the mucous membrane to the outside. The airways of the lungs contain rings of muscle. When the passageways are irritated by some allergen, these muscles can constrict. The respiratory tract is a common site for infections. Upper respiratory tract infections are probably
7968-404: The ribcage; a diaphragmatic surface, which faces downward toward the diaphragm; and a mediastinal surface, which faces toward the center of the chest, and lies against the heart, great vessels, and the carina where the two mainstem bronchi branch off from the base of the trachea. The alveoli are tiny air sacs in the lungs where gas exchange takes place. The mean number of alveoli in a human lung
8064-407: The ribs, to avoid breaking them. If the first thrust does not solve the choking, it can be repeated several times. The use of abdominal thrusts is not recommended for infants under 1 year of age due to risk of causing injury, so there are adaptations for babies (see more details further below), but a child that is too big for the babies' adaptations would require normal abdominal thrusts (according to
8160-451: The setting of long term foreign body aspiration. Cough is seen in 80% of foreign body aspiration cases, and shortness of breath is seen in 25%. People may be unable to speak, attempt to use hand signals to indicate they are choking, attempt to force vomiting, or clutch at their throat. An observed or recalled episode of choking, with sudden onset of any of the below respiratory and skin signs and symptoms while eating or handling small objects,
8256-598: The size of the body). Besides, abdominal thrusts should not be used when the victim's abdomen presents problems to receive them, such as pregnancy or excessive size; in these cases, chest thrusts are advised (see more details further below). Although it is a well known method for choking intervention, the Heimlich Maneuver is backed by limited evidence and unclear guidelines. The use of the maneuver has saved many lives but can produce deleterious consequences if not performed correctly. This includes rib fracture, perforation of
8352-574: The study which was significantly lead by the document "LifeVac: A Novel Apparatus to Resuscitate a Choking Victim" which were evaluated by the Journal of the American Red Cross Scientific Advisory Council (American Red Cross). This procedure has modifications for infants (babies under 1 year-old) , for the people with problems in the belly as the pregnant or too much obese people , for the disabled victims in wheelchair , for
8448-409: The tar from smoking accumulates over time, causing the lungs to work harder to repair themselves. Tuberculosis is one of many other infections that occurs in the lower respiratory tract. You can contract this infection from airborne droplets, and if inhaled you are at risk of this disease. This is a bacterial infection that deteriorates the lung tissue resulting in coughing up blood. This infection
8544-455: The tendency to insert object in their mouth as they explore the environment. Because a child's airway is smaller in diameter than that of an adult's, smaller objects can more often cause airway obstruction in children. Additionally, infants and young children generate a less forceful cough than adults, so coughing may not be as effective in relieving airway obstruction. Risk factors of foreign body airway obstruction for people of any age include
8640-454: The trachea due to gravity. There is also a risk of causing further damage (inducing vomiting, for instance) by using a finger sweep technique. There are no studies that have examined the usefulness of the finger sweep technique when there is no visible object in the airway. Recommendations for the use of the finger sweep have been based on anecdotal evidence. The majority of choking injuries and fatalities occurs in children aged 0–4, highlighting
8736-418: The trachea, through the bronchial tubes, and into the lungs. The entire tract is protected by the rib cage, spine , and sternum . In the lungs, oxygen from the inhaled air is transferred into the blood and circulated throughout the body. Carbon dioxide (CO 2 ) is transferred from returning blood back into gaseous form in the lungs and exhaled through the lower respiratory tract and then the upper, to complete
8832-600: The use of alcohol or sedatives , procedures involving the oral cavity or pharynx , oral appliances, or medical conditions that cause difficulty swallowing or impair the cough reflex . Conditions that can cause difficulty swallowing and/or impaired coughing include neurological conditions such as stroke, Alzheimer's disease , or Parkinson's disease . In older adults, risk factors also include living alone, wearing dentures , and having difficulty swallowing. Children and adults with neurological, cognitive, or psychiatric disorders are at an increased risk of choking and may experience
8928-406: The victim is a woman, the zone of the pressure of the chest thrusts would normally be above the level of the breasts. If the first thrust does not solve the choking, it can be repeated several times. Since 2015, several anti-choking devices were developed and released to the market. They are based on a mechanical vacuum effect, without a power source. Most use an attached mask to make a vacuum from
9024-499: The victim's head up and down, to reposition it trying to open an entrance for the air, and then giving another rescue breath . After the rescue breaths, this resuscitation returns to the 30 initial compressions, in a cycle that repeats continually, until the victim regains consciousness and breathes, or until the object is extracted but a defibrillation is needed to solve a cardiac arrest (read below). Defibrillation can also be needed, because an unconscious victim of choking can suffer
9120-438: The victim's heart. Anyway, a choking victim that is already unconscious needs to receive (even with no more delay) an anti-choking cardiopulmonary resuscitation (CPR) for unconscious adults and children. It is not valid for infants less than one year old, who require a special adaptated CPR for unconscious babies (described further below). The anti-choking cardiopulmonary resuscitation (CPR) for unconscious adults and children
9216-400: The victim's tongue obstructs too much, or on a side with a base under the head) and then grasping or sweeping the stuck object with tools: thin kitchen tweezers, scissors (these used with care), forks and spoons (in a reverse position: introducing their handle) or even a toothpick (if other instruments were too much big for the case); but, anyway, the current protocols do not recommend extracting
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