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Cafe coronary: recognition, treatment and prevention.
The Nurse Practitioner
|June 1, 1989
Summary
Foreign body upper airway obstruction causes thousands of deaths annually. Prompt recognition and intervention with the Heimlich maneuver or, if necessary, cricothyrotomy, can save lives by dislodging blockages.
Area of Science:
- Emergency Medicine
- Critical Care
- Public Health
Background:
- Foreign body upper airway obstruction (FB-UAO) is a significant cause of preventable death in the US, accounting for over 3,000 fatalities yearly.
- Rapid recognition is crucial as hypoxia lasting only 4-6 minutes can lead to irreversible brain damage.
Purpose of the Study:
- To emphasize the importance of prompt recognition and effective intervention for foreign body upper airway obstruction.
- To highlight the efficacy of the Heimlich maneuver and cricothyrotomy in managing complete airway obstruction.
Main Methods:
- Review of established emergency procedures for foreign body upper airway obstruction.
- Description of the Heimlich maneuver (external subdiaphragmatic abdominal thrust) mechanism.
- Outline of cricothyrotomy as a secondary intervention for refractory cases.
Main Results:
- The Heimlich maneuver effectively creates an artificial cough by elevating the diaphragm, expelling obstructing foreign bodies.
- Cricothyrotomy is a viable invasive option when non-invasive methods fail.
- Training in proper treatment significantly reduces mortality from foreign body airway obstruction.
Conclusions:
- The Heimlich maneuver is the primary recommended procedure for complete upper airway obstruction.
- Cricothyrotomy should be performed by trained professionals when non-invasive techniques are unsuccessful.
- Widespread training in managing foreign body airway obstruction can prevent a majority of related deaths, particularly in vulnerable populations like children and the elderly.