Accidental Choking Among Hospitalized Patients in Pennsylvania: A 15-Year Retrospective Review


  • Elizabeth Kukielka, PharmD, MA, RPH Patient Safety Authority



choking, foreign body, food bolus, airway obstruction, abdominal thrusts, patient safety


Choking occurs when a foreign body becomes lodged in the airway and obstructs respiration. In the United States, over 5,000 deaths were attributed to choking in 2015. Among older adults, food is the most common cause of choking, and the death rate for choking events involving food is seven times higher among older adults than young children. We queried the Pennsylvania Patient Safety Reporting System (PA-PSRS) and identified 545 events related to accidental choking on food, beverages, medications, or other foreign bodies reported from 2004 to 2019. Patients who experienced a choking event were more often female (56%; 306 of 545), and they ranged in age from 6 months to 102 years, with a median patient age of 70 years (interquartile range = 54 to 83 years). Among choking events that specified the substance involved, food was the most common (80%; 424 of 528 events). The most common foods that patients choked on were meat or fish (n=77), sandwiches (n=38), and breads or cakes (n=31). Abdominal thrusts were the most common immediate response described in event reports, attempted in more than half of events (56%; 306 of 545). Prevention of accidental choking may involve timely assessment of risk factors that predispose a patient to choking, including age older than 60 years, tooth loss and presence of dentures, and underlying psychiatric or neurologic illness.

Author Biography

Elizabeth Kukielka, PharmD, MA, RPH, Patient Safety Authority

Elizabeth Kukielka ( is a patient safety analyst on the Data Science and Research team at the Patient Safety Authority. Before joining the PSA, she was a promotional medical writer for numerous publications, including Pharmacy Times and The American Journal of Managed Care. Kukielka also worked for a decade as a community pharmacist and pharmacy manager, with expertise in immunization delivery, diabetes management, medication therapy management, and pharmacy compounding.



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How to Cite

Kukielka, E. (2020). Accidental Choking Among Hospitalized Patients in Pennsylvania: A 15-Year Retrospective Review. Patient Safety, 2(3), 42–53.



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