In the healthcare setting, choking is referred to as “acute upper airway obstruction.” While uncommon, the results of an obstructed airway can be catastrophic, so healthcare personnel must be trained and ready to deal with this dire emergency. In a healthcare setting, such as a hospital, nursing home, or group home, there are relatively few conditions or events that rise to the level of a dire emergency. Acute upper airway obstruction is one such circumstance. A delay in recognizing or in treating an obstructed airway or failure to use proper techniques to resolve an obstruction can form the basis for a medical malpractice lawsuit.
How a Medical Malpractice Attorney Can Help
An experienced medical malpractice lawyer, like a medical malpractice lawyer in Cleveland, OH, will continually review medical literature to familiarize themselves with medical standards of care, guidelines, and recommendations. For example, a recent article in the New England Journal of Medicine (NEJM) provides valuable information about acute upper airway obstruction, its causes, diagnosis, and treatment. In the setting of emergency medicine and trauma medicine, the initial assessment of the patient focuses on the ABCs — airway, breathing, and circulation. The ABCs must be working before further assessment of the patient since without adequate airway, breathing, and circulation, no other treatment will be effective. A good attorney will keep up with medical news by reading journals like this.
The NEJM article begins by saying, “[a]cute upper airway obstruction is a life-threatening emergency and requires immediate assessment and intervention with little margin for error…” Outside of the healthcare setting, we recognize that swallowing virtually any object can pose a choking hazard. However, in the healthcare setting, airway obstruction can occur due to internal events, such as inflammation or collections of fluid or pus that compress the airway.
Treating Airway Obstruction
Treating acute upper airway obstruction in a hospital or other healthcare facility requires prompt diagnosis and immediate assessment of the patient to determine the best way to intervene and resume ventilation. Treatment options depend upon the cause of the airway obstruction which might include croup, epiglottitis, Ludwig’s angina (swelling due to abscess or infection), angioedema, a tumor, a foreign body, or a hematoma. Other causes include obstructive sleep apnea, asthma, and inhalation injury following a burn. Finally, trauma to the airway from a penetrating or blunt force can lead to obstruction.
Brain Injury Due to an Obstructed Airway
When a patient suffers anoxic brain injury as a result of an obstructed airway, a medical malpractice lawyer will want to review all records surrounding the patient’s care and treatment. In addition, it is important to interview eyewitnesses including physicians, residents, nurses, and family members, since the medical record often lacks potentially critical details. Note that in the course of responding to an emergency like an obstructed airway, the medical record will not be prepared until once the emergency has resolved and the record keepers have an opportunity to collect themselves. The record may be prepared with a medical negligence lawsuit in mind so that key facts are omitted or altered.
Preventing Problems Caused by a Blocked Airway
Many inflammatory conditions, such as epiglottitis and anaphylaxis, can be easily treated or prevented altogether. The NEJM article recommends a stepwise approach, called an algorithm, for resolving a difficult obstructed airway. Common interventions include intubation, oxygenation, ventilation or — when those fail — surgically opening the airway below the level of the obstruction. Any time that an obstructed airway results in severe, permanent anoxic brain injury, the patient’s medical records should be carefully reviewed by an experienced medical malpractice lawyer.
Thanks to Mishkind Kulwicki Law for their insight into how medical malpractice lawsuits can be formed due to problems that come from airway obstruction.