When to use the Heimlich maneuver and when it should be avoided; also, when a swallowed object requires a visit to the doctor or emergency room.

CHOKING AND SWALLOWED ITEMS

 Overview
When you swallow food, liquid, or a nonfood item, the swallowed object passes from your mouth through your throat and esophagus and into your stomach. The object will usually pass through the rest of the digestive tract without problems and appears in the stool in a few days. If food or a nonfood item gets stuck along the way, a problem may develop, requiring a visit to a health professional.

Sometimes when you try to swallow food, liquid, or a nonfood item, the swallowed object "goes down the wrong way" and gets inhaled into your windpipe or lungs (aspiration). This occurs most often during the 2nd year and in the sixth decade of life. Coughing is a normal reaction of the body to clear the throat and windpipe. The cough is helpful and may clear up the problem.

The situation may be more serious when:

  • Signs of choking (complete airway obstruction) are present from obstruction of the windpipe. When the windpipe is blocked, air cannot move in and out of the lungs. This is a life-threatening emergency. The Heimlich maneuver is used to clear and obstruction in adults and children over one year or age. Back blows and abdominal thrusts are used in babies under one year of age.
  • Signs of a partially blocked windpipe are present. When the windpipe is partially blocked, some air can still move in and out of the lungs. Coughing will often pop out the food or object and relieve the symptoms. The Heimlich maneuver is not recommended when the windpipe is partially blocked.
  • An object is stuck in the esophagus.
  • A poisonous object has been swallowed. Call the Poison Control Center right away if a known or suspected poisonous substance (such as a wild mushroom, plant, or chemical) has been swallowed.
  • A button disc battery has been swallowed.
  • An object doesn't show up in the stool within 7 days.

Some types of objects cause more concern when they are swallowed. These include:

  • Sharp objects, including an open safety pin, a bone, toothpick, needle, razor blade, or broken thermometer.
  • Long objects, including:
  • In adults and children, an object 2 in. (5.08 cm) or longer.
  • In infants and toddlers, an object 1.25 in. (3.18 cm) or longer.
  • Large objects that may get stuck in the digestive tract and require removal, including:
    • In adults and children, objects that are quarter-sized1 in. (2.54 cm) in diameter or larger.
    • In babies and small children, objects that are 0.75 in. (1.92 cm) in diameter or larger.
  • Your doctor may recommend tests, such as an X-ray, endoscopy, or upper gastrointestinal (GI) series, to help find the object if it doesn't come out in the stool, or if an inhaled object is not coughed out. Your doctor may then recommend a procedure to remove the object or may simply encourage you to continue to check the stool for the passage of the object.

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