Cafe coronary: recognition, treatment and prevention

Cafe coronary or foreign body upper airway obstruction claims more than 3,000 deaths each year in the United States. Early recognition of airway obstruction is imperative, because hypoxia of only four to six minutes' duration may result in irreversible brain damage. Fortunately, the foreign body preventing adequate air exchange can often be dislodged and expelled once the correct emergency procedures are implemented. The Heimlich maneuver or external subdiaphragmatic abdominal thrust is recognized as the basic procedure for relief of complete larynx/trachea obstruction. This technique, by elevating the diaphragm, can force a sufficient quantity of air from the lungs to create an artificial cough that is often of adequate force and duration to expel the obstructing foreign body from the airway. If non-invasive procedures prove to be ineffective, a cricothyrotomy should be performed by trained rescuers. Many of the victims of foreign body airway obstruction are either children or elderly. Most foreign body airway obstruction deaths can be avoided if the rescuer has been trained in the proper treatment.