Choking Prevention Across the Lifespan: Evidence-Based Strategies

Choking is a leading cause of unintentional injury death in children <5 and adults >65. Prevention targets food, objects, and behavior.

Infants & Young Children (Highest Risk)

• Food: No whole grapes, cherry tomatoes, hot dogs (cut lengthwise then quartered), nuts, popcorn, hard candy, raw carrot/apple chunks, peanut butter globs, marshmallows until age 4.
• Feeding posture: Upright, supervised, no walking/running/eating in car.
• Objects: Keep coins, buttons, beads, balloons, batteries, magnets, small toy parts out of reach (CPSC small parts cylinder test).

School-Age & Adolescents

• Teach: chew thoroughly, no talking/laughing with food, no food games ("chubby bunny").
• High-risk: athletes with mouthguards (ensure proper fit), teens with alcohol/drug impairment.

Adults & Older Adults

• Dysphagia screening (stroke, dementia, Parkinson's, post-intubation).
• Denture fit; medication-induced xerostomia.
• Food texture modification (IDDSI framework) per SLP assessment.

Universal Skill: Heimlich Maneuver (Abdominal Thrusts)

• Adult/child >1 yr: Standing, fist above navel, upward thrusts.
• Infant <1 yr: 5 back blows (head down) → 5 chest thrusts (2 fingers, sternum).
• Pregnant/obese: Chest thrusts.
• Self-administered: Lean over chair back, thrust abdomen.

CPR/First Aid certification (AHA/Red Cross) every 2 years for caregivers. Prevention + readiness saves lives.