A Forensic Study of the Foreign Body Airway Obstruction and Its Emergency Treatment_West China Medical Journal

Authors：

 NIZi-xiang ,  YIXu-fu , LIUMin

West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YIXu-fu, Email: yixufu@tom.com

Keywords：

Foreign body airway obstruction; Heimlich maneuver; Forensic pathology

DOI：

10.7507/1002-0179.20150415

Video：

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Objective To explore the forensic pathology features of foreign body and its emergency treatment: Heimlich maneuver. Methods We carried out a review of relevant literature and autopsy findings of 8 cases of foreign body suffocation at West China Forensic Identification Center of Sichuan University from 2000 to 2012. Results The most common foreign body reported was undigested food. Children, old people and middle-aged men who were drunk were vulnerable to choking. The most effective resuscitative procedure in such cases was Heimlich maneuver, but it had been noted to result in significant intra-abdominal and intra-thoracic injuries if performed incorrectly. Conclusion It is necessary to take some preventive measures to avoid the foreign body, and the publicity of Heimlich maneuver to reduce the incidence and mortality of foreign body is important.

Citation： NIZi-xiang, YIXu-fu, LIUMin. A Forensic Study of the Foreign Body Airway Obstruction and Its Emergency Treatment. West China Medical Journal, 2015, 30(8): 1447-1451. doi: 10.7507/1002-0179.20150415 Copy

1.	Dolkas L, Stanley C, Smith AM, et al. Deaths associated with choking in San Diego county[J]. J Forensic Sci, 2007, 52(1):176-179.
2.	易旭夫. 婴儿灌药至气管、支气管内后死亡1例[J]. 法律与医学杂志, 1996, 3(4):182-183.
3.	曹恒明, 纪佩珍, 李培华, 等. 呼吸道异物1523例分析[J]. 徐州医学院学报, 2002, 22(5):429-431.
4.	Heimlich HJ. The heimlich maneuver:prevention of death from choking on foreign bodies[J]. J Occup Med, 1977, 19(3):208-210.
5.	Heimlich HJ. Pop goes the café coronary[J]. Emerg Med, 1974(6):154-155.
6.	Heimlich HJ. A life-saving maneuver to prevent food-choking[J]. JAMA, 1975, 234(4):398-401.
7.	Van der Ham AC, Lange JF. Traumatic rupture of the stomach after Heimlich maneuver[J]. J Emerg Med, 1990, 8(6):713-715.
8.	Bintz M, Cogbill TH. Gastric rupture after the Heimlich maneuver[J]. J Trauma, 1996, 40(1):159-160.
9.	Fearing NM, Harrison PB. Complications of the heimlich maneuver:case report and literature review[J]. J Trauma, 2002, 53(5):978-979.
10.	Wolf DA. Heimlich trauma:a violent maneuver[J]. Am J Forensic Med Pathol, 2001, 22(1):65-67.
11.	Feeney SN, Pegoli W, Gestring ML. Pancreatic transection as a complication of the Heimlich maneuver:case report and literature review[J]. J Trauma, 2007, 62(1):252-254.
12.	Otero Palleiro MM, Barbagelata LC, Fernandez Pretel MC, et al. Hepatic rupture after Heimlich maneuver[J]. Ann Emerg Med, 2007, 49(6):825-826.
13.	Nowitz A, Lewer B, Galletly DC. An interesting complication of the Heimlich manoeuvre[J]. Resuscitation, 1998, 39(1/2):129-131.
14.	Cecchetto G, Viel G, Cecchetto A, et al. Fatal splenic rupture following Heimlich maneuver:case report and literature review[J]. Am J Forensic Med Pathol, 2011, 32(2):169-171.
15.	Ujjin V, Ratanasit S, Nagendran T. Diaphragmatic hernia as a complication of the Heimlich maneuver[J]. Int Surg, 1984, 69(2):175-176.
16.	Razaboni RM, Brathwaite CEM, Dwyer WA. Rupture jejunum following Heimlich maneuver[J]. JACEP, 1979, 8(2):473-475.
17.	Entel RJ, Hakki AH. Bone scan after the Heimlich maneuver[J]. Clin Nucl Med, 1996, 21(3):251.
18.	Haynes DE, Haynes BE, Yong YV. Esophageal rupture complicating Heimlich maneuver[J]. Am J Emerg Med, 1984, 2(6):507-509.
19.	Sam JS. Dangers of the Heimlich maneuver for esophageal obstruction[J]. N Engl J Med,1989, 320(14):1016.
20.	Meredith MJ, Liebowitz R. Rupture of the esophagus caused by the Heimlich maneuver[J]. Ann Emerg Med, 1986, 15(1):106-107.
21.	Chillag S, Krieg J, Bhargava R. The Heimlich maneuver:breaking down the complications[J]. South Med J, 2010, 103(2):147-150.
22.	Ayerdi J, Gupta SK, Sampson LN, et al. Acute abdominal aortic thrombosis following the Heimlich maneuver[J]. Cardiovasc Surg, 2002, 10(2):154-156.
23.	Lin PH, Bush RL, Lumsden AB. Proximal aortic stent-graft displacement with type Ⅰ endoleak due to Heimlich maneuver[J]. J Vasc Surg, 2003, 38(2):380-382.
24.	Desai SC, Chute DJ, Desai BC, et al. Traumatic dissection and rupture of the abdominal aorta as a complication of the Heimlich maneuver[J]. J Vasc Surg, 2008, 48(5):1325-1327.
25.	Chapman JH, Menapace FJ, Howell RR. Ruptured aortic valve cusp:a complication of the Heimlich maneuver[J]. Ann Emerg Med, 1983, 12(7):446-448.

1. Dolkas L, Stanley C, Smith AM, et al. Deaths associated with choking in San Diego county[J]. J Forensic Sci, 2007, 52(1):176-179.
2. 易旭夫. 婴儿灌药至气管、支气管内后死亡1例[J]. 法律与医学杂志, 1996, 3(4):182-183.
3. 曹恒明, 纪佩珍, 李培华, 等. 呼吸道异物1523例分析[J]. 徐州医学院学报, 2002, 22(5):429-431.
4. Heimlich HJ. The heimlich maneuver:prevention of death from choking on foreign bodies[J]. J Occup Med, 1977, 19(3):208-210.
5. Heimlich HJ. Pop goes the café coronary[J]. Emerg Med, 1974(6):154-155.
6. Heimlich HJ. A life-saving maneuver to prevent food-choking[J]. JAMA, 1975, 234(4):398-401.
7. Van der Ham AC, Lange JF. Traumatic rupture of the stomach after Heimlich maneuver[J]. J Emerg Med, 1990, 8(6):713-715.
8. Bintz M, Cogbill TH. Gastric rupture after the Heimlich maneuver[J]. J Trauma, 1996, 40(1):159-160.
9. Fearing NM, Harrison PB. Complications of the heimlich maneuver:case report and literature review[J]. J Trauma, 2002, 53(5):978-979.
10. Wolf DA. Heimlich trauma:a violent maneuver[J]. Am J Forensic Med Pathol, 2001, 22(1):65-67.
11. Feeney SN, Pegoli W, Gestring ML. Pancreatic transection as a complication of the Heimlich maneuver:case report and literature review[J]. J Trauma, 2007, 62(1):252-254.
12. Otero Palleiro MM, Barbagelata LC, Fernandez Pretel MC, et al. Hepatic rupture after Heimlich maneuver[J]. Ann Emerg Med, 2007, 49(6):825-826.
13. Nowitz A, Lewer B, Galletly DC. An interesting complication of the Heimlich manoeuvre[J]. Resuscitation, 1998, 39(1/2):129-131.
14. Cecchetto G, Viel G, Cecchetto A, et al. Fatal splenic rupture following Heimlich maneuver:case report and literature review[J]. Am J Forensic Med Pathol, 2011, 32(2):169-171.
15. Ujjin V, Ratanasit S, Nagendran T. Diaphragmatic hernia as a complication of the Heimlich maneuver[J]. Int Surg, 1984, 69(2):175-176.
16. Razaboni RM, Brathwaite CEM, Dwyer WA. Rupture jejunum following Heimlich maneuver[J]. JACEP, 1979, 8(2):473-475.
17. Entel RJ, Hakki AH. Bone scan after the Heimlich maneuver[J]. Clin Nucl Med, 1996, 21(3):251.
18. Haynes DE, Haynes BE, Yong YV. Esophageal rupture complicating Heimlich maneuver[J]. Am J Emerg Med, 1984, 2(6):507-509.
19. Sam JS. Dangers of the Heimlich maneuver for esophageal obstruction[J]. N Engl J Med,1989, 320(14):1016.
20. Meredith MJ, Liebowitz R. Rupture of the esophagus caused by the Heimlich maneuver[J]. Ann Emerg Med, 1986, 15(1):106-107.
21. Chillag S, Krieg J, Bhargava R. The Heimlich maneuver:breaking down the complications[J]. South Med J, 2010, 103(2):147-150.
22. Ayerdi J, Gupta SK, Sampson LN, et al. Acute abdominal aortic thrombosis following the Heimlich maneuver[J]. Cardiovasc Surg, 2002, 10(2):154-156.
23. Lin PH, Bush RL, Lumsden AB. Proximal aortic stent-graft displacement with type Ⅰ endoleak due to Heimlich maneuver[J]. J Vasc Surg, 2003, 38(2):380-382.
24. Desai SC, Chute DJ, Desai BC, et al. Traumatic dissection and rupture of the abdominal aorta as a complication of the Heimlich maneuver[J]. J Vasc Surg, 2008, 48(5):1325-1327.
25. Chapman JH, Menapace FJ, Howell RR. Ruptured aortic valve cusp:a complication of the Heimlich maneuver[J]. Ann Emerg Med, 1983, 12(7):446-448.

West China Medical Journal

A Forensic Study of the Foreign Body Airway Obstruction and Its Emergency Treatment

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