Asphyxiation

What is asphyxiation?

Asphyxiation (as-fik-see-ay-shen) is when your body doesn’t get enough oxygen. Asphyxiation affects how you breathe. It may cause you to pass out (unconsciousness). It can also cause death.

Other names for asphyxiation include asphyxia and suffocation.

What are the main kinds of asphyxiation?

There are many different kinds of asphyxiation, including:

• Mechanical asphyxia. Mechanical asphyxiation is when an object or a physical force stops you from breathing. It also includes body positions that may prevent you from breathing.
• Traumatic asphyxia. Traumatic asphyxiation is a type of mechanical asphyxiation. A strong external force (trauma) to your thoracic cavity (a chamber in your body surrounded by your rib cage, muscles, tissue and skin) causes traumatic asphyxiation. It forces blood from your heart back through your veins to your neck and brain.
• Perinatal (birth) asphyxia. Birth asphyxia is when your baby doesn’t get enough oxygen right before, during or right after birth.
• Compressive (compression) asphyxia. Compression asphyxiation is a type of mechanical asphyxiation. A strong external force presses on your chest or abdomen. Examples include a large crowd pushing against your body (like at a concert) or someone sitting or kneeling on your chest.

How common is asphyxiation?

Asphyxiation is very common.

In 2016, nearly 19,000 people in the United States died from asphyxiation.

From 2018 through 2019, asphyxiation was the leading cause of accidental death in children under 1 year old.

How does asphyxia affect my body?

Asphyxia can affect your body in different ways:

Foreign object blockage

If a foreign object is blocking your airway, your body retains carbon dioxide (hypercapnia). Oxygen can’t reach the tissues in your body (hypoxia).

Your body will try to start breathing again, which may look frightening. Your eyes may bulge, your skin may change color, your hands may grab at your throat and you may weakly cough.

Your blood pressure and heart rate increase sharply (spike), your blood pH drops and your body releases catecholamines. Catecholamines are hormones that play an important role in your body’s fight-or-flight response.

Eventually, your blood pressure drops, and your heart slows down.

You must remove the blockage or have someone administer treatment immediately. If you don’t, your heart will stop beating (cardiac arrest) in four to five minutes.

Drowning

In approximately 10% of drownings, your vocal cords suddenly stop working (laryngospasm) when you first gasp water. You’ll die from asphyxiation, but you won’t have any water in your lungs.

In the other 90% of cases, the muscles in your glottis (the space between your vocal cords) relax, and water enters your lungs.

Your body will quickly absorb freshwater. Freshwater will dilute the plasma in your blood and break down your red blood cells (hemolysis).

Saltwater will draw fluids from your circulatory system into your lungs and decrease the amount of plasma in your blood.

What are the symptoms of asphyxiation?

Symptoms of asphyxiation include:

• Shortness of breath (dyspnea).
• Quick or deep breathing (hyperventilation).
• Loss of consciousness.
• Coughing.
• Raspy or hoarse voice.
• Inability to speak.
• Face or lip discoloration (red, purple, blue or gray).
• Difficulty or inability to swallow.
• Memory loss.
• Involuntary urination (peeing) or defecation (pooping).
• Dizziness.
• Headaches.

What causes asphyxia?

There are many different causes of asphyxiation, including:

• Anaphylaxis. Anaphylaxis (an-ah-fi-lak-sis) is a severe allergic reaction, usually from food allergies. Other severe anaphylaxis symptoms may include vomiting and swelling of your hands, feet and face (lips).
• Asthma. Asthma is a chronic (long-term) condition that affects your lungs. Triggers include air pollution, exercise, pet dander (dried skin flakes) and tobacco smoke.
• Positional asphyxiation. Positional asphyxiation occurs when your body is in a position that blocks or obstructs your breathing. It most commonly occurs in newborn babies or infants who aren’t strong enough to reposition their bodies.
• Chemical asphyxiation. Chemical asphyxiation occurs when you breathe in a substance that replaces the oxygen in your lungs. The chemical prevents oxygen from reaching other parts of your body. Chemicals that can cause asphyxiation include carbon monoxide, cyanide, hydrogen sulfide and chemicals in household cleaning products.
• Opioids overdose. Opioids are chemicals that interact with your nerve cells to reduce pain. If you take too many opioids, your breathing can slow down and stop.
• Drowning. Drowning is asphyxiation due to your head going under a liquid (submersion), usually water.
• Foreign object blockage (obstruction). Foreign objects block your airways. Obstructions may result from improperly swallowing food or choking on vomit due to alcohol poisoning.
• Strangulation. Strangulation is when a hand, rope, cord or another object around your neck blocks your airway.

How is asphyxiation diagnosed?

Asphyxiation is a medical emergency that requires immediate treatment. If you’re with a child or adult who suddenly can’t breathe, ask them if they’re choking. If they can’t respond, look for the following signs and symptoms:

• Clutching at their throat (the universal sign for telling people you’re choking).
• Shallow coughing.
• Wheezing.
• Inability to talk.
• Passing out.

If a baby can’t breathe, look for changes to their behavior, including difficulty breathing, a weak cry or a shallow cough.

Should I give someone who can’t breathe something to drink?

No, you shouldn’t give someone who can’t breathe something to drink. A drink may further obstruct the airway.

What tests will be done to diagnose asphyxia?

If a foreign object is partially obstructing your airway, your healthcare provider may order X-rays or a bronchoscopy to locate and remove the blockage.

How is asphyxia treated?

Asphyxia treatment depends on what’s causing your breathing difficulties. Treatment may include:

• Cardiopulmonary resuscitation (CPR). Chest compressions help keep blood flowing to vital organs until your heartbeat returns.
• Heimlich maneuver. Abdominal thrusts help dislodge airway obstructions.
• Medications. Medications help treat certain causes of asphyxiation. They may include an inhaler for asthma, epinephrine (EpiPen®) for an allergic reaction or naloxone (Narcan®) for an opioid overdose.
• Mouth-to-mouth resuscitation. Mouth-to-mouth resuscitation helps stimulate breathing. You can apply mouth-to-mouth resuscitation to people who’ve drowned or overdosed on opioids.
• Oxygen therapy. A breathing tube, oxygen mask, nose tube or ventilator delivers oxygen to your body.

How can I prevent asphyxiation?

The best way to prevent asphyxiation is to be careful. If you’re with someone who can’t breathe, dial 911 immediately.

When eating, chew your food slowly and speak only after swallowing. Keep an eye on young children when they’re eating. Encourage them to eat small bites and avoid talking until they’ve swallowed their food.

If you have food allergies, carry an EpiPen with you at all times. Check the ingredients label of anything you eat.

It’s a good idea to swim with at least one other person. If you can’t swim, wear a life jacket.

Keep an inhaler with you at all times in case you have an asthma attack.

Install carbon monoxide detectors in your home. Have a trained professional do yearly inspections of your fuel-burning appliances. Appliances include your furnace, water heater and oven.

What can I expect if I have asphyxia?

The outlook for people who immediately treat the cause of their asphyxiation is good.

If you don’t immediately treat asphyxiation, long-term or permanent effects may include stroke, brain injury or death.

What questions should I ask my healthcare provider?

• What should I do if someone isn’t breathing?
• Do I have any long-term or permanent health effects from not being able to breathe?
• Do I have any food allergies?
• Should I see an allergist?
• How can I prevent asphyxia in the future?

A note from Cleveland Clinic

Asphyxiation is a scary condition that stops oxygen from entering your body. You may feel panic if you or someone you’re with is showing signs of asphyxiation. However, it’s important to remain calm. Look for signs of troubled breathing, including hands clutching at the throat. Call 911 and follow the dispatcher’s directions. The sooner you address the cause of asphyxiation, the greater your chances of avoiding long-term or permanent health problems.