What is 'cafe coronary?'

'Cafe coronary' is poorly named because it has nothing to do with a heart attack. This condition got its name because onlookers may think they are witnessing a heart attack when a diner is really choking to death. 'Cafe coronary' is blockage in the upper airway, usually caused by food or vomit stuck in the throat. The blockage causes choking and can be life-threatening.

How does choking occur?

Choking occurs when a piece of food or some other object gets stuck in the airway. Chicken and fish bones and pieces of meat that haven't been chewed properly get stuck in the throat easily. The danger of choking increases if someone has been drinking alcohol because he or she may be careless about chewing food well.

What are the symptoms?

Symptoms of choking may include:

• inability to talk

• wheezing

• forceful coughing

• clutching the throat or chest as a sign of distress

• fainting.

How is it treated?

If a person is choking but still able to breathe and cough and not turning a bluish color, let him or her try to cough up the object. If he or she is having trouble breathing and turning blue, give first aid by doing the Heimlich maneuver, which is described in the next section.

Emergency treatment may be necessary. If an object can't be removed, the person may need an emergency operation called a tracheostomy. This is a procedure in which the doctor makes a cut through the skin of the throat and inserts a tube to let air into the lungs.

How can I help someone who is choking?

The following first aid is general advice, not meant to replace proper training and practice necessary to handle such emergencies. Basic life-saving classes are available from organizations such as local hospitals or the Red Cross in most communities.

Treatment for an adult who is conscious is called the Heimlich maneuver. Have someone call 911 for emergency help while you start the Heimlich maneuver:

• Lean the person forward slightly and stand behind him or her.

• Make a fist with one hand.

• Put your arms around the person and grasp your fist with your other hand near the top of the stomach, just below the center of the rib cage.

• Make a quick, hard movement, inward and upward.

If this movement doesn't dislodge the object, repeat it several times.

If the person is unconscious and has stopped breathing, begin CPR (cardiopulmonary resuscitation) as taught in your community. For this to be successful, you must first clear the airway as follows:

• Kneel down next to the person.

• Put the heel of your hand against the middle of the abdomen, slightly above the navel.

• Put your other hand on top.

• Press inward and upward with both hands.

If this doesn't work, open the person's mouth and try to remove the object with your finger.

Once the airway is cleared, begin CPR.

How long will the effects last?

The choking sensation will last as long as the food or object remains stuck. After a minute or so of being unable to breathe or cough, the person may faint.

After the object is removed, the throat may be sore if it was scratched by the obstruction.

What can be done to help prevent choking?

Be careful to chew foods thoroughly, especially when you are drinking alcoholic beverages.

Avoid laughing and horseplay during meals to reduce the chance of inhaling small pieces of food that can get stuck in the throat.