Could this happen in your program? Food choking
According to the National Safety Council (NSC), choking on food or other objects is the fourth-leading cause of accidental injury or death in the United States. Studies have shown that people with intellectual and developmental disabilities are nearly 11 times more likely to die from respiratory-related conditions, often linked with difficulties swallowing (dysphagia), choking, and aspiration. In a review of U.S. death certificates, choking is commonly listed as contributing to the cause of death among people with Down syndrome, intellectual disabilities, and cerebral palsy.
The NSC also notes that there is a higher risk for choking among infant, children, and elderly populations. The absence or loss of teeth can affect the ability to chew food adequately, thereby increasing choking risk. Mental health status can also play a role. The National Institute of Health has found that oral health problems are more prevalent in those with severe mental illness and are one of the most common comorbidities related to addiction.
To prepare for choking events in your program, we’ve compiled the below scenario as a training tool. Review the text with your team and discuss the approved response plan:
Incident
Sean has a major depressive disorder and a history of suicide attempts. He was admitted to the Behavioral Health Unit (BHU) of a general hospital. While there, Sean fell and hit his head and was transferred to the medical unit for follow up. While on the medical unit, he began to display swallowing difficulties and was administered a swallow evaluation. After reviewing the results, Sean’s doctor wrote an order for him to be on a ground food diet and recommended that he be supervised during mealtimes. Sean was eventually transferred back to the BHU, but his dietary requirements were not included in his treatment plans and staff were not aware of the changes to his diet consistency or the requirement to supervise him during meals.
Sean was served pork chops, french fries, and a green salad for dinner. He began to eat but then stopped, stood up, and started to run from the room. Suddenly he began to cough forcibly, and some food came out of his mouth. Staff offered Sean a glass of water and encouraged him to drink it but he lost consciousness and fell to the floor. Staff saw that Sean’s mouth was full of food and he was starting to turn blue. They administered abdominal thrusts and called a “code blue” for assistance. Staff from other areas of the hospital responded. It was very crowded and chaotic while staff were trying to resuscitate Sean.
A crash cart was brought to the cafeteria and staff attempted to suction his airway but the batteries on the portable suction machine had expired and there was not an extension cord on the crash cart. Staff administered CPR until an extension cord was located. The suction device successfully removed the food that was blocking Sean’s airway and he was transferred to the intensive care unit for monitoring.
Discussion questions:
- What would you have done differently?
- What errors can you identify?
From January 1, 2020, through June 2022, the Justice Center received nearly 1,000 reports of food-related choking incidents. A complete review of these findings can be found in our Spotlight on Prevention toolkit linked below.
CLICK HERE
