Both Impair Air Flow but in Different Ways

By Rod Brouhard, EMT-P  | Reviewed by Richard N. Fogoros, MD

The word choking has been misused for so long it’s become an accepted way of describing strangulation. But they’re not the same thing. Both terms refer to a restriction of air caused by something other than a disease. The key difference is that choking is an internal event, while strangulation is caused by external forces.


Choking is also known as a foreign body airway obstruction. It occurs when something is physically in the way of air moving in and out of the trachea (windpipe). In most cases, choking is caused by food, which gets stuck in the trachea and directly blocks airflow. But it’s also possible that something can get lodged in the esophagus, the tube that transports food to the stomach, and squeeze the trachea from behind. Either way, the object is inside the body when it causes choking.
Treatment for choking depends on the severity of the situation—for instance, mild choking may be resolved by encouraging the person to cough forcefully. Treatment also depends on the age of the patient. Infant choking is treated differently than choking in adults and children older than 1. In this group, severe choking—when the person can’t speak, cry, cough, or breathe—is best treated by giving five sharp blows between the person’s shoulder blades with the heel of your hand or by performing the Heimlich maneuver.


Whether it occurs intentionally or accidentally, strangulation is when anything compresses the neck enough to restrict airflow to the trachea. It’s incorrect to say that someone was “choked” by another person; the correct terminology would be “strangled.”
The treatment for strangulation is the immediate removal of the device or object that’s impairing breathing. Then, call 911. A medical evaluation is crucial if someone’s been strangled. An injury to the trachea may not appear to be serious right away, but swelling in the tissues around the trachea can lead to a secondary restriction of airflow a few minutes after the neck is free.
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