Bolus death
In bolus death (Greek bolos 'lump') or bite death , a foreign body stuck in the throat causes a vagal reflex by pressure on the larynx nerve plexus , which leads to a sudden cardiovascular arrest . This must be distinguished from bolus obstruction, in which the patient suffocates by aspirating a foreign body .
clinic
In bolus death, the patient collapses silently after the foreign body has got stuck in the throat. This is in contrast to suffocation, where the patient gasps for breath and turns blue.
As with aspiration, the main cause is not or insufficiently chewed food. In addition, other swallowed objects can also be the cause of bolus death, for example dental prostheses, small children's toys or coins.
prevention
Observe the generally accepted advice to eat slowly and carefully, to chew the food well and not to speak with your mouth full.
Bolus death can be prevented by strong blows on the back and / or the use of the Heimlich handle named after Henry Heimlich by the first aider . In the cooperative or unconscious patient, the more experienced first aid provider can also try to remove the foreign body by grasping it directly in the mouth. If the foreign body cannot be removed and respiratory and cardiac arrest occurs, cardiopulmonary resuscitation is the method of choice for the first aider .
People at particular risk
Small children very often put foreign objects in their mouths and are therefore more exposed to the risk of bolus death. However, the Heimlich maneuver should not be used for children under one year of age. Instead, the child should be held on the forearm with the head pointing downwards and attempted to loosen the foreign body with strong blows between the shoulder blades. Under no circumstances should the child be held by the feet and allowed to hang down, as serious damage to the cervical spine can occur here. Here, too, a grip in the mouth can help, as the first aider only has a few seconds to remove the foreign body. Strong blows to the back can also cause the foreign body to detach from the vibration.
People who eat food in an uncontrolled manner are also at risk of dying from a bolus death. B. heavily drunk people or people who have psychological problems such. B. " Endogenous psychoses from the schizophrenic circle ". Due to minimal organic brain damage with susceptibility to interference from protective reflexes , reflex coordination during the swallowing process may no longer function properly in this group of people, especially after a long, chronic course of the disease .
history
The term 'bolus death' was originally introduced in 1908 by Georg Doll . He used it to describe death from suffocation caused by chunks of food. 1913 postulated Kolisko the larynx shock and related Vagusreflextod. Since then, bolus death has been mentioned in various publications as a reflex cardiac arrest due to a foreign body obstruction.
Individual evidence
- ^ I. Wirth et al.: Forensic medicine: Basic knowledge for investigative practice. (= Fundamentals of Criminology. Volume 43). Verlag Hüthig Jehle Rehm, 2012, ISBN 978-3-7832-0021-8 , p. 142, (online) ,
- ↑ AJ Handley, R. Koster, K. Monsieurs et al: European Resuscitation Council guidelines for resuscitation 2005. Section 2. Adult basic life support and use of automated external defibrillators. In: Resuscitation. 67, Suppl 1, 2005, pp. S7-S23. PMID 16321717 .
- ↑ B. Brinkmann, K. Püschel: Asphyxiation. Springer-Verlag, Berlin / Heidelberg 1990, ISBN 3-642-75757-X , pp. 30–40, Bolus death - suffocation or vagus reflex , accessed on March 4, 2016.
literature
- Mohamed Youssry Abdel Aziz: The Bolus Death in Forensic Medicine . Dissertation . University of Tübingen , 1977, DNB 790871408 .
- Katja Doubek: Lexicon of the strange types of death. Strange varieties and forms of death from A for rampage to Z for potassium cyanide . Eichborn, Frankfurt am Main 2000, ISBN 3-8218-1521-3 . (Paperback edition: Piper 3408 "Ein Eichborn-Lexikon", Munich 2002, ISBN 3-492-23408-9 / ISBN 3-492-23280-9 , keyword "Bolustod")
- Frank Marusch: The Bolus Death: An Analysis of Literature and Forensic Medical Section cases. Dissertation. Humboldt University of Berlin , 1990, DNB 911473718 .
- Thomas Maurer: Forensic medical examinations on bolus death. Dissertation. Münster 1984, DNB 840997523 .
- Pschyrembel: Clinical Dictionary. 262nd, revised and expanded edition. de Gruyter, Berlin et al. 2011, ISBN 978-3-11-021152-8 , keyword: “Bolus death”.
- I. Wirth, A. Schmeling : Forensic medicine - basic knowledge for investigative practice. 3. Edition. Kriminalistik Verlag, Heidelberg / Munich / Landsberg / Frechen / Hamburg 2012, ISBN 978-3-7832-0021-8 . ( accessed online March 6, 2016)
