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Can Choking Cause Brain Damage? Find Out Here!

Michael
Public Health Specialist & Safety Advocate
Updated on Jul 30, 2024
Can Choking Cause Brain Damage? Find Out Here!

Choking can quickly turn dangerous, potentially leading to brain damage if not addressed swiftly. This article explains how the lack of oxygen during a choking incident can harm the brain. 

We'll guide you through crucial first-aid techniques to minimize the risk of choking and prevent brain damage. Read on to ensure you're prepared to act effectively in case of a choking emergency.

What is Choking?

Choking, or foreign body airway obstruction (FBAO), occurs when an object is accidentally swallowed and either falls into or becomes lodged in the airway, causing partial or complete blockage. This prevents air from entering the lungs, leading to difficulty breathing and, in severe cases, cessation of breathing.

Choking can cause hypoxia, a deficiency in oxygen that can become life-threatening if not promptly addressed. The most serious consequence is hypoxic-ischemic brain injury, the primary cause of mortality in such incidents, followed by pulmonary hemorrhage. Other frequent complications include neurological impairment, recurrent pneumonia, lung abscess, and bronchiectasis.

How Choking Can Lead to Brain Damage?

How Choking Can Lead to Brain Damage

The mechanism by which choking causes brain damage primarily involves foreign objects obstructing the airway, leading to insufficient ventilation and subsequent cerebral hypoxia. 

Hypoxia is a severe health threat that occurs when tissues receive insufficient oxygen due to inadequate blood flow or low blood oxygen levels, compromising the body’s ability to perform normal physiological functions

The brain requires a substantial amount of oxygen and can survive only a few minutes under hypoxic conditions. During a choking incident, if oxygen cannot effectively enter the bloodstream, the brain’s oxygen supply diminishes. This decrease impairs the energy metabolism of brain cells, leading to insufficient energy production and difficulty in maintaining normal cellular functions.

Moreover, hypoxia disrupts the chemical equilibrium within brain cells, resulting in cellular damage. Prolonged lack of oxygen can ultimately cause cell death or apoptosis. Additionally, when hypoxic conditions improve and oxygen supply is restored, a significant number of free radicals are produced. These free radicals attack the cells, causing further cellular damage.

Timeline: How quickly can brain damage occur following hypoxia caused by choking?

  • Less than 1 minute of brain hypoxia: Usually, it does not cause permanent brain damage. Brief hypoxia may lead to mild cognitive impairments, but most symptoms quickly disappear once normal breathing is restored.

  • More than 1 minute of brain hypoxia: May result in severe headaches, blurred vision, and confusion. If normal breathing is restored promptly, there may not be long-term effects; however, you should still seek medical attention.

  • More than 4 minutes of brain hypoxia: Begins to cause permanent brain damage. The patient might lose consciousness. The reduced blood flow caused by hypoxia leads to damage in specific areas of the brain, resulting in the death of neurons that are highly sensitive to oxygen, such as those in the hippocampus. This affects memory and learning abilities.

  • More than 6 minutes of brain hypoxia: Death may be imminent. In such cases, the brain will suffer severe and extensive damage. Even if heartbeat and breathing are restored through emergency measures like CPR, the patient may still face permanent severe brain damage, a vegetative state, or death.
Timeline of brain damage caused by choking

Symptoms and Signs of Brain Damage Post-Choking

The severity of brain damage due to choking depends significantly on the duration and degree of hypoxia (oxygen deprivation).

When severe choking leads to a complete airway blockage, no air can enter the lungs, often causing loss of consciousness within minutes. If the brain remains without oxygen for more than 4 to 6 minutes, permanent damage may occur. 

Here are some common symptoms and signs:

  1. Cognitive Impairments:
    • Memory loss
    • Difficulty concentrating
    • Confusion
    • Reduced ability to process information
  2. Physical Symptoms:
    • Headache
    • Fatigue
    • Weakness
    • Loss of coordination or motor skills
    • Nausea or vomiting
  3. Behavioral Changes:
    • Irritability
    • Anxiety
    • Mood swings
    • Depression
  4. Speech and Language Issues:
    • Slurred speech
    • Difficulty finding words
    • Problems understanding speech
  5. Sensory Impairments:
    • Vision problems, such as blurred vision or double vision
    • Reduced sense of taste or smell
  6. Severe Cases:
    • Seizures
    • Loss of consciousness
    • Coma
    • Permanent neurological damage

Prompt medical evaluation is crucial after a choking incident to assess for potential brain damage, especially if the person was unconscious for any period. 

Choking Statistics and High-Risk Choking Hazards

Choking can occur at any age, but children and the elderly are more vulnerable. According to the National Safety Council, choking is a leading cause of injury and death among children, particularly those under 4 years old. 

In the U.S., approximately 66 to 77 children under the age of 10 die each year from food choking. Annually, more than 10,000 children aged 14 and under are treated for food-related choking incidents.

Additionally, the choking mortality rate among the elderly is also notably high. In the U.S., over 76,000 adults aged 65 and older die from choking, with 6.5% of these deaths attributed to food choking.

Food is the leading cause of choking and represents about 60% of non-fatal choking incidents. Among them, hot dogs are the most common food causing choking. Other high-risk foods include hard candies, grapes, nuts, and carrots, which are similar in size to the airway. The elderly are also prone to choking on foods, particularly on meats such as steaks and cooked meatballs.

Beyond food, small objects and toys frequently cause choking among children. Research shows that latex balloons are the primary cause of choking-related deaths in children under four years old. Coins, particularly those smaller than 20 cents, are also notable choking hazards.

What to Do if Someone is Choking?

If you are the only rescuer present, immediately begin choking first aid measures before calling for emergency assistance. Do not drive the choking person to the emergency room yourself, as this could cost valuable time needed for emergency care.

If others are present, have them call for emergency help right away. Then proceed with choking first aid measures.

Common Methods for Handling Choking

  • Encourage Coughing: Encourage the choking person to cough vigorously, which can help dislodge the obstruction.

  • Heimlich Maneuver (Abdominal Thrusts): Stand behind the choking person, wrap your arms around their waist, and perform quick, forceful upward and inward thrusts to expel the obstruction.

  • Chest Thrusts: Administer quick thrusts to the center of the chest to clear the obstruction.

Below are step-by-step guides for saving different groups of people who are choking:

  1. Infant Choking First Aid: Complete Step-by-Step Guide
  2. Child Choking: Symptoms and First Aid [Step-by-Step]
  3. Adult Choking: Symptoms and First Aid [Step-by-Step]
  4. Pregnant Choking First Aid: Complete Step-by-Step Guide
  5. Self Heimlich First Aid: Complete Step-by-Step Guide

Conclusion

Choking can lead to respiratory failure, cardiac arrest, brain damage, or even death. Hypoxia resulting from choking that persists for four to six minutes can cause irreversible brain damage or prove fatal. 

Immediate action to clear a fully blocked airway is critical; delaying can significantly reduce the chances of survival and complete recovery. If the obstruction is promptly removed and normal breathing is restored, the patient usually has a good chance of full recovery. Regardless of the outcome, a professional medical evaluation in a hospital after a choking incident is essential to ensure the safety and health of the individual.

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