Choking Incidents among Psychiatric Patients: Retrospective Analysis of Thirty-one Cases from the West Bologna Psychiatric Wards

Objective: To determine the rate of choking incidents among the psychiatric population of 4 inpatient facilities, classifying the incidents according to their probable etiology. Method: All incidents recorded over 18 months were retrospectively analyzed for demographic variables, psychiatric and medical diagnoses, and drug therapy at the time of incident. Where possible, patients underwent psychiatric, neurological, and medical examination. Results: Thirty-one incidents were recorded involving 18 patients at a rate of one incident every 56.32 months’ hospitalization per person. One case proved fatal, one patient died several weeks after the incident from aspiration pneumonia, and 5 patients needed reanimation or the Heimlich manoeuvre. Etiological classification showed that incidents due to bradykinetic dysphagia and “fast eating ” were the most numerous, even among the fatal or grave cases. Conclusions: Various simple, effective preventive measures emerge from the study. (Can J Psychiatry 1997;42:515–520) Key Words: psychiatric institutions, psychiatric patients, airway obstruction, psychotropic drugs, eating habits Choking while swallowing food or drinks is a cause ofdeath that has long been known and studied among the psychiatric population. Most of the literature relates to psy