Choking question?

Question

When someone is choking does it mean that the food or drink they are consuming actually gets into the trachea and then into the lungs or is this prevented by the person coughing?

How would you know if something had gotten as far as the lungs

Answer 1

Food or water touching the vocal cords initiates a powerful reflex, causing a person to cough. And even more potent reflex exists at the carina, the point where the trachea bifurcates (separates) into the two main bronchi. Nevertheless, food or liquid sometimes gets past. Most liquid and solid aspirates are coughed up, eg) President Bush and the pretzel. But some get stuck in the bronchial tubes or even enter the lungs.

Inspection may reveal uneven expansion of the chest wall. Listening with the stethoscope may reveal wheezing or unequal breath sounds on one side from the other. Later rales may be in evidence if there is significant aspiration pneumonia. Rarely one can appreciate fremitus or changes in the percussion note. Marie's answer was fine and the results from her suggestions are more definitive, but she should have tried the above before sending the patient to Roentgen Alley.

Answer 2

If you're choking, then by definition something is blocking air from getting past the trachea and into the bronchi.  If you're truly choking, then you are not able to cough, because the airway is sealed (but in common terminology, of course people do say they're "choking" when they're coughing and spluttering).  Coughing is the automatic response of the body to try and dispel anything except air that's going down the airway.

When something--liquid or solid--actually reaches the lungs, that is called "aspiration" and it causes various problems depending on what and where it is.  Choking is higher up and is an immediate problem because it's stopping anything from getting in at all--and you need to breathe or you'll die.  If you aspirate something but it doesn't cause a complete blockage, you can still breathe, but it will irritate the airways, so you'll cough.   It could also block off a section of the lung, which could then collapse, giving you other symptoms.  If you aspirate something contaminated with bacteria, it can cause a lung infection and you get pneumonia (this is why you see them rolling people to the side if they throw up when unconscious--it's to try and keep them from aspirating the vomitus).

If something solid gets as far as the lungs, you'd need an X-ray (if it's dense enough) or bronchoscopy (a tube put down the throat and into the bronchi) to find it.  Something like a peanut will not show up on X-ray because it's the same general density as the rest of the body's tissues.  If it's liquid, you probably won't know until it causes problems (an infection) because small amounts of liquid are not visible on imaging.  Enough liquid will show up as a "white-out" area on X-ray.

Answer 3

If it went into the lungs they would be able to breathe, as the airway wouldn't be blocked, it can then be surgically removed.

Answer 4

A man found that a peanut had found its way into his lung. They  thought it was Cancer .

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