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David Mittleman
David Mittleman
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Choking Warning; Hot Dogs or Sausage for Children Under 4

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As we approach the 4th of July and being firing up our grills to make America’s favorite summer food – the hot dog – please remember that hot dogs (like grapes, raw carrots, and gel candies) can get stuck “like a cork” in your throat and cause complete airway obstruction.  For children under 4 years old, it is very important to cut their hot dogs or sausage lengthwise twice – then chop into small pieces.  Even apples should be cut into pea-sized pieces for small children to reduce the chances of choking.  When uncut hot dogs are served to older children, stress the importance of sitting down and chewing properly (without talking), before each swallow.  We all are at risk, although the majority of fatal choking occurs in the very young and the very old.

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Immediate treatment is needed for complete obstruction, the Heimlich maneuver can be a life-saver.  The most important thing to know about the Heimlich maneuver is when to perform it.  Most choking cases do not cause complete airway obstruction and do not require the Heimlich maneuver.  Most importantly with a complete airway obstruction, you must immediately call 911.  The Heimlich maneuver is only to be initiated if there is a complete airway obstruction and the victim is unable to cough, talk, or breathe and is turning purple or blue.

Chevalier Quixote Jackson, M.D., lived in Pennsylvania from 1865 to 1958.  Through his mechanical ingenuity, team work, in patient care, and treating skills, he reduced the mortality rate of children presenting to the hospital with complete airway obstruction from 98% to 2%.  In 2011, a US National Safety Council report state that choking caused 4,500 deaths (all ages) in the United States in 2009.  The majority of deaths from choking and suffocation occur in the first year of life.