Baby chokes on water: Choking – The Pediatric Clinic

Choking – The Pediatric Clinic

What is choking?

Choking is the coughing spasm and sputtering that happen when liquids or solids get into the windpipe. A child’s cough reflex will clear the windpipe of liquid within 10 to 30 seconds. Complete blockage occurs when solid food (for example, a piece of hot dog) or a foreign object (such as a small toy) gets stuck. (It can also occur with severe croup.) If this happens a child is unable to breathe, cry, or speak. The child will be in a state of panic and, if the obstruction isn’t removed in 1 or 2 minutes, the child will pass out.

What should I do if my child is choking?

Encourage coughing.

As long as your child is breathing and coughing, do nothing except encourage him to cough the material up by himself. The main purpose of your child’s cough reflex is to clear the windpipe. Don’t give your child anything to drink because fluids may take up space needed for the passage of air.

Give FIRST AID.

• IF BREATHING STOPS in a child OVER 1 YEAR OLD give high abdominal thrusts.
• Grasp the child from behind, just below the lower ribs but above the navel, in bear-hug fashion.
• Make a fist with one hand and fold the other hand over it.
• Give a sudden upward and backward jerk (at a 45-degree angle) to try to squeeze all the air out of the chest and pop the lodged object out of the windpipe.
• Repeat this upward thrust 10 times in rapid succession, until the object comes out.
• If the child is too heavy for you to suspend from your arms, lay him on his back on the floor. Put your hands on both sides of the abdomen, just below the ribs, and apply sudden, strong bursts of upward pressure.

IF BREATHING STOPS in a child UNDER 1 YEAR OLD, give back blows and chest compressions.

• Place him or her facedown in a 60-degree incline over your knees or on your forearm.
• Deliver 5 blows with your hand between the shoulder blades in rapid succession.
• If breathing has not resumed, lay the child on the floor and apply 5 rapid chest compressions (chest thrusts) over the lower third of the breast bone (sternum) using 2 fingers. Alternate back blows and chest thrusts. Repeat until the object comes out. Reason to avoid abdominal thrusts under the age of 1 year: Risk of liver or spleen laceration)

IF THE CHILD OR INFANT PASSES OUT, give mouth-to-mouth breathing.

• Quickly open the mouth and look inside to see if there is any object that can be removed with a sweep of your finger (usually there is not).
• Then begin mouth-to-mouth breathing. Air can usually be forced past the foreign object temporarily until help arrives.
• If mouth-to-mouth breathing doesn’t move the chest, repeat the abdominal thrusts or chest compressions.

Call the rescue squad (911) IMMEDIATELY.

Call the rescue squad (911) immediately in all cases of choking on a solid object.

In general, choking on liquids is temporary and harmless. Call the rescue squad if your child chokes on a liquid and turns blue, becomes limp, or passes out.

How can choking be prevented?

Choking can be life-threatening, so try to prevent it from happening by not giving young children foods or small objects that are most likely to cause choking.

Foods that are most likely to cause choking are nuts of any kind, sunflower seeds, orange seeds, cherry pits, watermelon seeds, gum, hard candies, popcorn, raw carrots, raw peas, raw celery, and tough meats. Do not give these hard foods to children who are less than 4 years old. They do not have enough molar teeth to chew them well and they may not understand that some seeds should be spat out rather than swallowed.

The soft foods that most often cause complete blockage and death are hot dogs, sausages, large pieces of any meat, grapes, gummy candy, and caramels. These foods must be avoided or chopped up before serving. Warn babysitters and older siblings not to share these foods.

Choking on a rubber balloon is the leading cause of deaths resulting from choking on objects other than foods. Most incidents occur when children suddenly inhale a deflated balloon they have been chewing. Warn your child never to chew or suck on pieces of rubber balloons. Even teenagers have died from this freak accident. Chewing on an inflated balloon is also dangerous because it could burst. Mylar helium balloons are much safer. Rubber balloons should only be used with strict supervision. Other items that can cause choking in young children include coins, marbles, pen or marker caps, and small button-type batteries.

what to do if baby chokes on water Archives

How do I know if my child is dry drowning?

A parent wrote to me with this question…

What are the signs of dry drowning? How do we, as parents, know how much water is too much?

– Concerned parent

Dry drowning and secondary drowning, which is also sometimes referred to as delayed drowning, are not accepted medical terms. Here’re the facts. so

Hyponatremia or Water Intoxication

Hyponatremia or water intoxication results when the normal balance of electrolytes in the body is pushed outside safe limits by excessive water intake.

– Wikipedia

It Takes a Lot of Water for It to Be Fatal

So, how much is a lot of water? The recommended daily amount of drinking water for the 6 to 12-month-old baby is two to eight ounces on top of the water they get from breast milk or formula.

It’s doubtful that your baby would accidentally swallow anywhere near two to eight ounces or more of pool water during a swimming lesson or at bathtime.

So, the likelihood of your little one ending up with hyponatremia is very scarce. But in the off chance that your baby swallows a large amount of water (which is unlikely), it can lead to Hyponatremia.

The symptoms of Hyponatremia are vomiting, dizziness, lethargy, confusion, behavioral changes, completely clear urine, and swelling of the face, arms, or legs. If your baby shows these signs, seek medical attention immediately.

Aspiration Pneumonia

In some of these incidents, the child contracted aspiration pneumonia — an infection that develops from water trapped in the lungs. But that isn’t drowning, Dr. Peter Wernicki, member of the American Red Cross Scientific Advisory Council said. It’s a rare condition, he added, and a child with it would show symptoms, including coughing and labored breathing many hours after leaving the water, and parents would know something was wrong.

– Dr. Peter Wernicki

It’s Been So Blown Out of Proportion

How Do I Know If My Child Is Dry Drowning?

So now we believe that anytime a child inhales or swallows a little bit of pool water that it’s life-threatening. It’s not the case.

If your baby ingests or drinks a little bit of water unintentionally, you’ll know because he’ll cough for a few seconds after the incident. Don’t worry; it doesn’t harm your baby. And when or if this happens, remain calm. Your baby looks to you for social referencing. So if you stay calm, he will remain calm.

Remember, it’s only if the coughing lasts for hours and is accompanied by labored breathing that you would have reason to be concerned. so How Do I Know If My Child Is Dry Drowning?

You may have read some stories about children who didn’t show any signs of “dry or secondary drowning” (other than a brief coughing fit) after an incident at the pool and then went to bed that night and never woke up.

Wernicki says, “A child doesn’t (act fine) for eight hours and then die (from drowning).”  

There’s been no documented case of an asymptomatic child dying from drowning days after leaving the pool.

How Do I Know If My Child Is Dry Drowning?

To Prevent Hyponatremia, Aspiration Pneumonia or Actual Drowning Do the Following:

• When you swim with your child, stay within arms reach.
• Fence in your pool, spa, and landscape water features.
• Always swim in a lifeguarded area.
• Learn swimming and water safety survival skills.
• Provide close and constant attention to children you are supervising in or near water. so
• Children, inexperienced swimmers, and boaters should wear U.S. Coast Guard-approved life jackets.
• Also, know what to do in an emergency. If a child is missing, check the water first.
• And know when to call 911 and have easy access to reaching or throwing equipment, a cell phone, life jackets, and a first aid kit.

How Do I Know If My Child Is Dry Drowning?

I hope that I have helped to relieve your concerns. Have you ever known a single person who has succumbed to hyponatremia, or aspiration pneumonia? I don’t know anyone or anyone who knows anyone.

We’ve all inhaled or swallowed pool water when we’ve been swimming, and if you’re reading this, then you survived.

Swallowing disorder

Violation of swallowing – the causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Violation of the act of swallowing, or dysphagia, is due to the impossibility of passing the food bolus formed in the oral cavity through the oropharyngeal or pharyngeal-esophageal part into the stomach.

It is necessary to distinguish between true dysphagia and pseudodysphagia, which is manifested by a sensation of a lump in the throat, but is not accompanied by a violation of the act of swallowing.

The process of swallowing is regulated by the nerve center, which is located in the medulla oblongata, so damage to the brain structures leads to a violation of the swallowing reflex. The act of swallowing involves the muscles of the oropharynx and esophagus, the pathology of which also leads to dysphagia.

Varieties of swallowing disorders

Swallowing disorders are usually a symptom of gastrointestinal, oncological or neurological diseases.

The act of swallowing consists of three phases: oral (carried out voluntarily), pharyngeal (carried out reflexively) and esophageal (also carried out reflexively). Depending on the stage at which the difficulty in swallowing occurs, we can talk about the cause of this phenomenon. In some cases, difficulty in swallowing is caused by a violation of the act of swallowing in combination with soreness (odynophagia) . Sometimes there is a feeling that when swallowed, a lump gets stuck in the throat, at other times there is no such complaint. In some diseases, fear of swallowing develops ( phagophobia ) , the person is afraid of choking, feels that he cannot swallow food. This condition can occur with anxiety disorders, hysteria, previous negative cases. Some people can feel the process of food passing through the esophagus. However, this sensitivity is not associated with food retention in the esophagus or with its blockage. Sometimes patients complain of difficulty swallowing, when in fact they have a full stomach after a meal, especially when the hasty meal is accompanied by swallowing air.

Depending on the reason that does not allow food to enter the stomach, there are functional and organic dysphagia. Functional violation of the act of swallowing is caused by a disorder of contraction and relaxation of the muscles of the upper esophageal sphincter or the oropharynx and esophagus due to a violation of the nervous regulation. It is also possible the organic cause of the disorder of the act of swallowing due to a mechanical obstruction or narrowing in the oropharynx or esophagus.

Possible causes of swallowing problems

One of the leading causes of swallowing disorders are the consequences of a stroke .

Clinical manifestations of swallowing disorders in this case include choking or coughing when eating; salivation; accumulation of food behind the cheek or its loss from the mouth, difficulty in taking tablet medicines.

Dysphagia is also a symptom Parkinson’s disease and is detected in almost half of the patients.

Degenerative processes in the central nervous system eventually lead to damage to the muscles of the oropharynx, which is accompanied by a violation of swallowing and speech. The symptom often manifests itself in the later stages of the disease.

Dyskinesia of the esophagus leads to a violation of the act of swallowing, which may be accompanied by atony and paralysis or spasm of the esophagus (esophagus spasm).

By atony of the esophagus can lead to brain damage in head injuries, hemorrhages or brain tumors and disruption of the autonomic nervous system in systemic diseases (systemic scleroderma, myasthenia gravis, etc.).

As a rule, the leading clinical signs are the symptoms of the underlying disease. With systemic scleroderma , connective tissues are affected with involvement of the skin, musculoskeletal system and internal organs in the pathological process. The esophagus in this pathology is affected more often than other organs, which is manifested by difficulty in swallowing. Dysphagia at myasthenia gravis (muscle weakness) is often the only symptom of the disease and is manifested by difficulty swallowing dry and poorly chewed food, especially when lying down.

Another cause of esophageal dyskinesia is spastic dysphagia (esophagospasm) , which occurs as a result of psycho-emotional stress in patients with esophagitis, gastric ulcer, etc. In addition, esophagospasm develops in diseases that are accompanied by a general convulsive syndrome (epilepsy).

Clinically, spasm of the esophagus is manifested by retrosternal pain and impaired swallowing.

Among the rather rare causes of swallowing disorders is achalasia of the cardia . With this disease, the intermuscular nerve plexuses are affected, which leads to the impossibility of relaxing the lower esophageal sphincter and esophageal peristalsis. Violation of the tone of the esophagus is accompanied by dysphagia, vomiting and pain at the time of swallowing food.

The contractile function of the esophagus is impaired at dysfunction of the upper esophageal sphincter, oculopharyngeal muscular dystrophy (a hereditary disease that affects the muscles of the face and head). In these cases, dysphagia is caused by damage to the neuromuscular tissue of the esophagus, which is accompanied by muscle weakness.

Organic causes of swallowing disorders include primarily neoplasms of the head, neck, esophagus and mediastinum . Since the anatomical space of the mediastinum is limited, growing tumors can compress the venous trunks, which is accompanied by the development of the syndrome of the superior vena cava (impaired outflow of venous blood from the upper body). Compression of the trachea and esophagus by a crowded venous trunk may be accompanied by symptoms of suffocation and dysphagia.

One of the frequent causes of violation of the act of swallowing is the appearance of diverticula of the esophagus – sac-like protrusions of the walls of the esophagus towards the mediastinum. This causes perspiration, increased salivation and a sensation of a lump in the throat.

Esophageal obstruction that causes dysphagia can develop in infectious processes in the esophagus or oropharynx (for example, with tonsillitis, abscesses and phlegmon), as well as in tuberculosis due to cicatricial narrowing of the esophagus.

Thyromegaly (enlargement of the thyroid gland) can also lead to a violation of the act of swallowing due to compression of the esophagus, but this process is observed only at a late stage of the development of the disease.

Against the background of psychosomatic disorders, hysteria, psychogenic dysphagia may occur, which is accompanied by other neurological symptoms (pseudo-stuttering, “lump in the throat”, etc.).

Which doctors should I contact?

It is important to remember that the initial symptoms of spasm and dysmotility of the esophagus can occur in children of the first year of life.

The appearance of the first symptoms of indigestion – regurgitation, sudden vomiting of unchanged food immediately after eating, pain when swallowing – requires immediate treatment
pediatrician.

If such symptoms are detected in an adult for a long time (more than a month), it is imperative to visit
therapist. Based on the results of the examination, the therapist can give a referral to
gastroenterologist or oncologist to examine the gastrointestinal tract. For neurological disorders associated with dysphagia, it is necessary to refer to
neurologist or psychotherapist.

Diagnostics and examinations

A preliminary diagnosis can be made after a thorough examination of the patient. At the same time, attention is paid to the duration of dysphagia and the nature of its course. For example, esophagitis is usually accompanied by short-term dysphagia. Rapid and steadily progressive symptoms of difficulty swallowing are characteristic of esophageal cancer. With benign narrowing of the esophagus (strictures, tumors), dysphagia is characterized by periodicity and occurs more often when swallowing solid food. With functional dysphagia due to diseases such as achalasia of the cardia or esophagus spasm, it is difficult to swallow both solid and liquid food.

In patients with systemic scleroderma, the characteristic feature is a skin lesion. The neurological nature of dysphagia is evidenced by such symptoms as speech impairment, hoarseness, tongue atrophy, as well as signs of neuromuscular lesions. To identify diseases that can disrupt the flow of food into the esophagus, examine the oral cavity and pharynx.

To detect dysfunction of the muscles of the mouth and pharynx, as well as organic changes, fluoroscopy with barium sulfate and esophageal manometry are performed; computed tomography of the larynx.

Treatment

Given the different causes of dysphagia, the doctor prescribes treatment only after the diagnosis is made. With a progressive form of dysphagia, which may indicate an oncological disease, a visit to the doctor cannot be postponed.

What should be done in case of violation of the act of swallowing?

With post-stroke dysphagia, while maintaining the swallowing reflex, soft, semi-liquid dishes are consumed.

The patient should take all medications in the presence of medical staff, drinking medicines with small sips of water in a half-sitting position.

If the swallowing function is not restored within three days, nutrition is carried out through a nasogastric tube.

If the cause of the violation of the act of swallowing is esophagitis or gastroesophageal disease, it is necessary to shorten the intervals between meals and reduce the portion size. It is not recommended to eat hot and cold dishes, food should be chewed thoroughly. It is advisable to limit the consumption of foods that cause irritation of the esophageal mucosa (fats, alcohol, coffee, chocolate, citrus fruits, etc. ).

After eating, you should avoid bending forward and not lying down for 1.5 hours. In addition, it is worth refusing to wear tight clothing, tight belts.

Sources:

1. Clinical guidelines “Acute respiratory viral infections (ARVI) in adults”. Developed by: National Scientific Society of Infectionists, Russian Scientific Medical Society of Therapists. – 2021.
2. Clinical guidelines “Paratonsillar abscess”. Developed by: National Medical Association of Otorhinolaryngologists. – 2021.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

When my husband began to choke on plain water, we didn’t know what to do

Six years ago, a Service to help people with amyotrophic lateral sclerosis (ALS) was established in Moscow. This is one of the most severe incurable diseases of the nervous system, in which signals from the brain stop coming to the muscles and they stop working. The causes of the disease are still unknown. In a short time, a person becomes deeply disabled. According to the latest data, there are from one to three ALS patients per 100,000 people.

Together with my husband – 50 years old, and our screamers are 49 each

When they met, she was 18, and he was 22. Both studied at the Moscow Institute of Chemical Engineering, at the same faculty, in the same group. She just finished school. He managed to serve in the army.

At first they talked in common companies, went on a hike in the Carpathians together. And then he began to accompany her home, and they sat for hours on the windowsill in the entrance – talking and kissing.

One day she returned from a trip and he met her at the train station with a huge bouquet of gladioli that could barely fit in his hands.

In the fourth year they signed. A year and a half later, they had twins – Sergey and Andrey.

“I came from the hospital, my husband has a session. He has to study for exams, and our children are screaming. It turned out that while one was sleeping, the other screamed, as soon as the second fell silent and, it would seem, it was possible to work out, the first one began to scream. There was a continuous cry at home … Now our “screamers” are already 49years,” says Galina Gennadievna.

With her husband – Mikhail Mikhailovich, whom she calls “Mikhalych” at home, they lived together for 50 years. We celebrated our golden wedding last year.

Both are already retired. Galina Gennadievna worked for many years at the Research Institute of Chemical Reagents and Highly Pure Chemical Substances. And her husband for more than 40 years – at the Research Institute of Long-Range Radio Communications (NIIDAR) – a designer and chief mechanic.

“Our family is friendly. I know that there are brothers and sisters who do not care about each other, and sometimes even quarrel. I was very afraid of this. And now I see that the sons are together, helping each other. My father and I are supported, and we support them. We gave birth to two grandchildren. And then they presented the long-awaited granddaughter, ”says Galina Gennadievna.

Galina and Mikhail Abramov

When my husband began to choke on plain water, we didn’t know what to do

In March 2016, Mikhail Mikhailovich developed the first signs of a disease that he and his wife had not even heard of then. Problems with speech began, he began to slur words, and then his mouth twisted. We went to the clinic. The doctor suggested a stroke. He said that the acute period has passed. He prescribed injections. They were not admitted to the hospital.

“My husband was doing exercises for the language, together we learned tongue twisters, sang songs… But speech became worse and worse. We spent the summer at the dacha, and in the autumn they again came to the doctor. Went to a neurologist. He quickly took her husband to the hospital. There they told me: “Read about ALS on the Internet.”

Mikhail Mikhailovich was sent to the Institute of Neurology. Myography was done – a diagnostic method in which the electrical activity of muscles is recorded at rest and during contractions. The professor suggested that her husband not say anything about the disease yet. And I didn’t speak for six months. My husband thought that he had a stroke, ”says Galina Gennadievna.

Six months later, when swallowing problems began and doctors started talking about installing a gastrostomy – a special tube through which food in a mushy or liquid state enters the stomach, Mikhail Mikhailovich finally found out about his disease.

“My husband’s swallowing and speech were getting worse. Honestly, it was very scary, because the doctors did not say anything, did not give any advice. Neither in the clinic, nor in neurology – nowhere. The disease is incurable – that’s all, – says Galina Gennadievna.

– We are adults and already old people. We understand that sometimes you can’t help. But absolutely nothing can be done! At least suspend, slow down the process… When you know what can be done, how you can stabilize or alleviate the condition, this gives at least some hope.”

When Mikhail Mikhailovich began to choke on ordinary water, the couple did not know what to do. Galina Gennadievna began to look for any information about this on the Internet and accidentally stumbled upon a free service for people with ALS.

“I applied there, they sent us a bunch of questionnaires. We even got scared at first. Thought they were scammers. Nobody needed us at all. .. And then I read that the Service was created on the basis of the Marfo-Mariinsky Convent of Mercy. It calmed me down,” says Galina Gennadievna.

I say what problems – and immediately organize a meeting with a specialist

Mikhail Mikhailovich was registered in December last year. Since then, it has been under the constant control of the Service’s specialists. Gastrostomy – according to the results of the analyzes – they did not install. Both platelets and VC (vital capacity of the lungs) were below normal.

“A curator is assigned to each ward,” says Galina Gennadievna. Our curator’s name is Tanya. If I need something, I call her and tell her that we have food problems, for example. The next day, they arrange a meeting with a specialist who tells me what is better to eat, in what form. A husband, for example, does not choke on soup, but choke on water. The experts of the Service recommended a certain thickener to us and told us a lot of other subtleties.

The Service is very helpful with care. If a person, for example, is lying down, relatives are given recommendations on how best to turn him so that there are no bedsores. My Mikhalych is still moving independently. True, he walks badly, stumbles, his legs do not rise, they do not obey. And my hands are getting weak.

We were also assigned a visiting nurse, Dasha. She calls regularly and comes when needed. It even helped me somehow. She came to Misha, but my right hand does not rise. Dasha gave me a massage. If you need to leave home somewhere, she can replace me.

And they helped us re-register the disability group from the third to the second in the Service. We were given recommendations on what exactly to issue, where to apply, how to communicate with social services in general.

Father Valery came to us, spoke to us, supported us. Then I had a separate conversation with my husband.

We are very grateful to the Service. All of their tips and tricks are incredibly helpful. And most importantly, there is nowhere else to learn.”

Let’s wallow

Despite the fact that Mikhail Mikhailovich’s hands are getting weaker, he continues to carve wood. He does amazing work.

He learned carving many years ago when he took his sons to art school. According to his wife, he mainly carves portraits – either Niccolo Paganini, then Andrei Rublev, or a Russian beauty in a kokoshnik. And recently he carved a temple in Feodosia. He handed over three of his works to the BAS Service.

“This hobby is a great thing. If a person has been constantly busy with something all his life, and this is more than 70 years, and suddenly one time – and is not busy with anything, it is very difficult, you can go crazy.

My husband hasn’t been talking at all lately. At first they tried to communicate with notes – it was not convenient. Then the grandson brought us a tablet and installed some kind of program.