It can be surprising to understand that the standard signs that choking – favor coughing – aren"t always present as soon as you gulp down fish or chicken bones. Or SpongeBob SquarePants.

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(Art: Chern Ling)



A male is lugged to the hospital, experiencing significant pain in the chest and back.

This could be a sign of a major heart, lung or blood vessel emergency, thinks Dr Michael Fung, consultant with the Acute and also Emergency care Department at Khoo Teck Puat Hospital (KTPH), a member that the National healthcare Group.

As the turned out, the male is eventually discovered to have actually a chicken bone stuck in his oesophagus.

It can be surprising to understand that the classic signs that choking – choose coughing – aren"t constantly present when we"ve swallowed something we shouldn"t have. 

Apart from the usual suspects such as fish, chicken and frog foot bones, fruit seeds, and meat or vegetable boluses, regional doctors have likewise pulled some stranger objects, such together dentures and broken spoon shards, native the oesophagus – and sometimes, further down the digestive system.

(Photo: Pixabay)

"Pins, needles and paperclips," likewise said Dr Ker Liang, consultant with nationwide University Hospital"s (NUH) department Of Otolaryngology (ENT) – Head & Neck Surgery, "are frequently held between the patient’s lip if working, and inadvertently swallowed by mistake".

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“We’ve had a patient through fever come in,” stated Dr Fung, and also that fever was caused by a deep abscess in the patient’s rectum, which to be eventually uncovered to be the result of an affected fish bone.

It had passed through his intestine and lodged chin in the rectum whereby it led to a painful arsenal of pus.


An typical of 10 patients who"ve swallowed miscellaneous dubious come through the NUH Emergency medicine Department on a day-to-day basis, while KTPH’s emergency room saw 15 choking situations last year the end of an median of 138,000 patient yearly.

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Babies and toddlers space the greatest swallowers the things, said Dr Karthik Balakrishnan, assistant professor of otolaryngology at the mayo Clinic.

“They discover the civilization in countless ways, consisting of putting points in their mouths. Castle don’t understand what have to go in and what shouldn’t so things deserve to accidentally be swallowed.” 

(Photo: Pixabay/un-perfekt)

Case in point: SpongeBob SquarePants, spotted no in a pineapple under the sea but on the X-ray that a 16-month-old boy.

The toddler from Saudi Arabia had been lugged to the hospital for swallowing something.

What physicians didn’t expect was a pendant that the grinning cartoon personality that had belonged to his sister, said Dr Ghofran Ageely, a radiology resident in ~ King Abdulaziz college Hospital in Jeddah.

Then, there are the inexplicable items that world have intentionally put down their throats.

Take the situation of the drunk 18-year-old college student from Bournemouth university in England, because that instance. That didn’t desire a night the partying to end, so he sent out his room an essential down the flower to protect against his girlfriend from acquisition him earlier to his dorm, follow to Mental Floss.

Lucky because that him, physicians told him that the secrets would “reappear” without surgery.


Individuals with specific psychiatric worries or dementia may additionally feel compelled to swallow non-food items.

“They simply seem to have actually a have to swallow things,” stated Dr troy Madsen, combine professor in ~ the university Of Utah school Of Medicine. 

“For them, swallowing things feels good.”

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In fact, in a 2010 study released in Clinical Gastroenterology and also Hepatology, the medical intervention that is required to eliminate swallowed foreign objects largely associated patients v psychiatric disorders.


Choking wake up when “the international object passes down the ago of the throat into the airway instead of the oesophagus,” said Dr Fung.

“If the is big enough come block the airway, the human being will be unable to breathe or speak.”

When this happens, no oxygen can enter the lungs.

The mind is the first organ come be affected and begins to dice within four to 6 minutes. Irreversible mind death can happen in as tiny as 10 minutes.

Urgent cases also include those with indicators such as vomiting blood, chest pain, ab pain or distension, and also blood in the stools, stated Dr Fung.

"Medical fist should definitely be sought if the swallowed object to be sharp and pointy together it can tear a feet in the cradle tract,” he said.

According come Dr Ker, many patients are "well after the choke episode but have throat pain" native the choking and coughing. 

Even so, all patients have to see a medical professional immediately, she advised.

"Most items take around 24 come 72 hrs to take trip from the mouth to the finish of our alimentary canal," stated Dr Ker.

"Larger items might take a longer time to travel down. The larger the item, the greater the risk of getting stuck, which may cause dangerous intestinal obstruction.

"Surgery is often essential to remove these big items before they enter the intestines."


Many world would think “Heimlich manoeuvre” once they view someone choking.

But the an approach can cause “serious abdominal injuries”, claimed Dr Fung.

“There was likewise a report the a shoulder injury continual by the well-intentioned person performing the manoeuvre.”

“It is essential to be correctly trained in a basic life assistance course prior to attempting the manoeuvre.

Additionally, it is crucial to describe one"s intentions to the choking person and also obtain his or her agreement prior to proceeding,” stated Dr Fung.

The move requires standing behind the choke person, wrapping her arms about him, and also performing a fist thrust into his upper abdomen.

“The influenced object does no ‘fly out’ as it comes free. Usually, the dislodges and also ends up in the ago of the person"s oral cavity,” that said.

If the choke is mild and also occurs in an adult, another means to assist is come encourage him to cough, stated Dr Ker.

This is when the human being is generally able to still speak, cry, sneeze or breathe. 

But once it is a an ext severe case of choking, and also coughing doesn"t help, Dr Ker suggested carrying the end five back blows:

Stand behind the person, slightly come one side.Lean him forward and support his chest v one hand.Use the heel of your hand (firm, bony area between the palm that the hand and also the wrist) to provide five blows between the shoulder blades.

If the blows don"t work, Dr Ker claimed to proceed with five ab thrusts:

Stand behind the person.Place her arms about his waist and also bend him forward.Clench a fist and place that right over his belly button.Put the other hand on optimal of her fist and also pull high solution inwards and also upwards.

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If the thrusts still don"t do a difference, call 995 because that an ambulance and also inform the operator that you have a choking situation.

Continue with the ago blows and abdominal muscle thrusts until aid arrives, stated Dr Ker. 

"If the person loses consciousness and also is not breathing, friend should start cardiopulmonary resuscitation (CPR) with chest compressions."