S17 · Choking
Risk ⚠ URGENT Safety and protection
Definition
Food or objects may block the airway.- Poor chewing
- rushing
- dementia
- large food pieces
- talking while eating
- Coughing
- clutching the throat
- unable to speak
- blue face
📋 Scenario
A patient with dementia eats large pieces of meat quickly while talking.
Subjective (S): Carer: "He stuffs his food into his mouth."
Objective (O): Dementia; eats fast; takes large bites; talks while eating; has not choked so far; several teeth missing.
Assessment tools for this scenario: CP-SAFE Safety & Falls Score
Validated scales to consider: Morse Fall Scale
**CarePath diagnosis:** Choking related to rushing, large food pieces and poor chewing (risk factors); no signs of the problem are present yet.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Cut food small and serve soft foods if needed. | Small, soft pieces are easier to chew and swallow, which matters because he has missing teeth and takes large bites. |
| Sit upright and supervise every meal. | An upright position lets food travel down the throat safely, and supervision means help is immediate if he begins to choke. |
| Remind to eat slowly without talking. | Slow eating with no talking lowers the chance that food enters the airway instead of the stomach. |
| Know how to give back blows and abdominal thrusts per protocol. | Knowing the correct technique means help can start in seconds, since a blocked airway can cause brain damage within minutes. |
| If choking: encourage coughing, give back blows and thrusts, and call emergency help at once. | A blocked airway is an emergency. Coughing may clear it, and back blows and thrusts are the standard steps, with emergency help called at once. |
**Expected outcomes**
- No choking episodes during the stay.
- Food cut small and meals supervised at every meal.
- Carers state how to respond to choking.
- If choking occurs: airway cleared and help called at once.
**Linking the data to the diagnosis**
A patient with dementia eats large pieces of meat quickly while talking, and the carer says, "He stuffs his food into his mouth." He also has several teeth missing. He has not choked so far, so this is a risk diagnosis based on rushing, large bites and poor chewing, not an actual event. The plan aims for no choking episodes, with food cut small and every meal supervised. Because choking can block the airway, the nurse treats any episode as urgent: help is called first, and back blows and thrusts are given while waiting.
CarePath diagnosis
Choking related to rushing, large food pieces and poor chewing (risk factors); no signs of the problem are present yet.
Interventions and rationale
Listed in priority order — for urgent statements the first action is to get help.
| Intervention | Rationale |
|---|---|
| 1. Cut food small and serve soft foods if needed. | Small, soft pieces are easier to chew and swallow, which matters because he has missing teeth and takes large bites. |
| 2. Sit upright and supervise every meal. | An upright position lets food travel down the throat safely, and supervision means help is immediate if he begins to choke. |
| 3. Remind to eat slowly without talking. | Slow eating with no talking lowers the chance that food enters the airway instead of the stomach. |
| 4. Know how to give back blows and abdominal thrusts per protocol. | Knowing the correct technique means help can start in seconds, since a blocked airway can cause brain damage within minutes. |
| 5. If choking: encourage coughing, give back blows and thrusts, and call emergency help at once. | A blocked airway is an emergency. Coughing may clear it, and back blows and thrusts are the standard steps, with emergency help called at once. |
Expected outcomes
- No choking episodes during the stay.
- Food cut small and meals supervised at every meal.
- Carers state how to respond to choking.
- If choking occurs: airway cleared and help called at once.
Linking the data to the diagnosis
A patient with dementia eats large pieces of meat quickly while talking, and the carer says, "He stuffs his food into his mouth." He also has several teeth missing. He has not choked so far, so this is a risk diagnosis based on rushing, large bites and poor chewing, not an actual event. The plan aims for no choking episodes, with food cut small and every meal supervised. Because choking can block the airway, the nurse treats any episode as urgent: help is called first, and back blows and thrusts are given while waiting.