Choking deaths

DEFINITION: Medical emergency that occurs when partial or complete obstruction of the airway interferes with breathing, depriving the body of the oxygen necessary to maintain life.

SIGNIFICANCE: Appropriate actions may be taken to prevent death in choking victims if others present recognize the signs of choking. Choking deaths may be mistaken for other types of deaths, such as suffocation, strangulation, or other causes of asphyxia, which may be intentional or accidental.

In 2023, there were about 5,529 choking deaths in the US, with a rate of roughly 1.7 deaths per 100,000 people. Choking is almost always accidental and largely preventable. The signs of active choking vary depending on the age of the person and the type of choking (partial or complete) involved.

In adults, choking on food commonly occurs in situations involving alcohol intoxication. Older adults and young children are at the highest risk for choking-related injury and death. For adults aged 65 years and older, age-related swallowing difficulties, denture use, and medication effects account for their higher risk. Children often choke as the result of putting small objects, such as coins or small toys, into their mouths and then unintentionally inhaling them into the trachea (airway). Children also sometimes choke because they have put large amounts of food into their mouths and have not chewed the food properly before swallowing; the objects enter the airway rather than the esophagus.

A choking victim who is able to cough or speak is receiving adequate oxygenation to sustain life; the appropriate action needed in such a situation is observation. The person should be encouraged to cough in an attempt to dislodge the object. A partial airway blockage, however, may progress to a complete blockage. When the airway is completely blocked, the victim is not taking in adequate oxygen and is unable to speak or cough. A blue discoloration of the lips and fingernails may become apparent.

A person who is choking may panic because of the lack of oxygen and fear of death. An adult may avoid seeking help in public owing to embarrassment, whereas a child may run from help out of fear. If the blockage is not resolved quickly, the individual will lose consciousness because of the lack of oxygen to the brain. At that point, the muscles in the airway will relax, but the object will remain in the airway unless the victim receives assistance from another person. If choking continues, the victim’s heart will eventually stop beating and death will occur. The US Food and Drug Administration (FDA) recommends following standard protocol, like the Heimlich maneuver, to help a person who is choking.

Medical and police personnel need to be aware of the signs of choking that may be present at the scene of a death. By thoroughly examining the scene and interviewing witnesses, emergency responders and police officers may aid the medical examiner in determining the cause and manner of death. Bruising of the neck is not typically seen in a choking victim. A person who has died from choking may have scratch marks at the neck from grabbing at the throat; if any skin is found under the fingernails, it will be the victim’s own. The eyes of a choking victim may appear bloodshot from vigorous coughing or from straining to relieve the blockage. As death occurs, the muscles relax. The bladder also relaxes, and urine may be present at the scene.

Bibliography

American Red Cross. American Red Cross First Aid: Responding to Emergencies. 5th ed., StayWell, 2006.

“Child Choking Statistics.” Gitnux, gitnux.org/child-choking-statistics/. Accessed 4 Feb. 2026.

“Choking.” National Safety Council, www.nsc.org/community-safety/safety-topics/choking. Accessed 4 Feb. 2026.

Lynch, Virginia A. Forensic Nursing. C. V. Mosby, 2006.

“More Elderly Americans Are Choking to Death. Are These Devices the Answer?” U.S. News & World Report, 14 July 2025, www.usnews.com/news/health-news/articles/2025-07-14/more-elderly-americans-are-choking-to-death-are-these-devices-the-answer. Accessed 4 Feb. 2026.

Stewart, Conor. “Number of Deaths Due to Choking in the United States from 1945 to 2023.” Statista, 26 Nov. 2025, www.statista.com/statistics/527321/deaths-due-to-choking-in-the-us/. Accessed 4 Feb. 2026.

“Update: FDA Encourages the Public to Follow Established Choking Rescue Protocols – FDA Safety Communication.” U.S. Food and Drug Administration, 13 Nov. 2025, www.fda.gov/medical-devices/safety-communications/update-fda-encourages-public-follow-established-choking-rescue-protocols-fda-safety-communication. Accessed 4 Feb. 2026.