Cough, Hack, Choke
February 28, 2017 7:50 AM   Subscribe

yanmd...What is first aid for pill aspiration?

i am pretty certain i aspirated one of the 200mg ibuprofen tablets i tried to swallow. i have a weird feeling in my airway and upper lungs and am coughing a bit. bit of a tickle in my throat too. this doesn't seem emergent/urgent. i have a good airway, and am breathing fine.

what's my game plan? sit, stand, lie down, walk around, drink water? try to hack it up? heimlich myself on a chair?

thx!
posted by j_curiouser to Health & Fitness (21 answers total)
 
I'd call the nonemergency line (this would be 111 in the UK, not sure about elsewhere) for advice.

Don't try to Heimlich yourself, because that can cause internal injury. You only want to Heimlich someone who's not breathing, and you're breathing fine.

I agree you're probably not in any immediate danger from what you've written here. However, because it's ibuprofen and not something else, and because it seems to be in your airway and not in your digestive system, you want to make sure no damage is done.

So, it's boring to say "seek medical advice" but, seek medical advice.
posted by tel3path at 7:55 AM on February 28, 2017 [3 favorites]


In this situation, I would talk to a pharmacist. You can call one or just walk into a Walgreens/whatever and go and ask. Pills dissolve and can be quite corrosive, and you're better safe than sorry here. I'm a big fan of asking pharmacists for help--they're a good stepping stone between what do I do and official medical help, knowledgable about drugs, and they're free and always available. They'll have more educated suggestions for what you can do.

Several years ago my cousin swallowed a pill with just a sip of water and went to bed. The pill didn't go down all the way and just sat dissolving in his throat all night. He got an ulcer in his esophagus because of it and it was this whole terrible thing. Don't do that.
posted by phunniemee at 8:12 AM on February 28, 2017 [7 favorites]


This sounds really dangerous to me, I would seek a medical opinion, urgent care at the very least.
posted by megafauna at 8:17 AM on February 28, 2017 [1 favorite]


> I'd call the nonemergency line (this would be 111 in the UK, not sure about elsewhere) for advice.

Yeah, we don't have that in the US. If you have health insurance, they may have number you can call and get advice from a nurse, otherwise try calling a pharmacy, or heading to an urgent care as soon as possible.
posted by rtha at 8:19 AM on February 28, 2017


Also if you want to continue trying to hack it up, I suggest bending way over, head as low as you can get it, and coughing. Let gravity help you.
posted by megafauna at 8:26 AM on February 28, 2017 [1 favorite]


I would go to urgent care. Aspiration can lead to lung infections.
posted by xyzzy at 8:27 AM on February 28, 2017 [1 favorite]


"what's my game plan? sit, stand, lie down, walk around, drink water? try to hack it up? heimlich myself on a chair?"

***I am NOT your Dr***
You can do many of those things, but I would avoid lying down for reasons mentioned above with a pill dissolving and causing ulceration. Also, definitely not the Heimlich maneuver, as that will cause damage - also mentioned above... probably the best option is to drink water and walk around. You want to gently dislodge it from wherever it has placed itself.

If, however, you do find yourself unable to get air - by all means try to J-thrust yourself on the edge of a chair or something sturdy! But that would be ONLY just before you pass out. Call an emergency line which can contact an ambulance for your breathing issues before that happens - just in case... and because anyone who has Heimlich done will need to seek medical attention afterwards, as airways may swell after such an event.
posted by itsflyable at 8:34 AM on February 28, 2017


Um... hopefully you're fine now but please make sure you have someone with you right now. If your airway becomes mostly or completely blocked you can die. Also, if your airway does become blocked, YES, do heimlich yourself with a chair or ask your friend to grab you around the middle, hold one hand in the other just above your belly button with thumb facing your belly , and give you quick, upward and inward thrusts to try to expel the pill.

Now that we've got that out of the way, then you can follow other steps to investigate what to do if you are still breathing OK.
posted by latkes at 8:38 AM on February 28, 2017


Inversion (positioning yourself so your head is lower than your torso) can help. This can be as simple as bending down from a standing position, or hanging off the back of a sofa *if* you've got someone to hold your legs.

It worked, in a more extreme case, for Isambard Kingdom Brunel. (Who built his own machine to do it, but you don't have to go that far.)
posted by Pallas Athena at 8:45 AM on February 28, 2017 [2 favorites]


You might be breathing okay now, but if that thing shifts, I imagine things could go badly very quickly. Please go to urgent care.
posted by delight at 9:36 AM on February 28, 2017 [1 favorite]


Um, this is NOT medical advice, just anecdotal, but this used to happen to me a lot as a child. My mom would give me a piece of bread and a big glass of water. I'd take a bite of bread, chew and swallow, and chase it with a big gulp of water. Repeatedly.In a few minutes, the stuck pill would come unstuck and go peacefully down my throat. Again, I am not a doctor, my mom is not a doctor and this is not medical advice...
posted by LaBellaStella at 9:50 AM on February 28, 2017 [1 favorite]


sitting up, walking around, drinking water...no change. but no prob, either...don't worry, i'll see someone if i deteriorate. thx
posted by j_curiouser at 10:01 AM on February 28, 2017


I like LaBellaStella's advice. Worth a shot, imo.
posted by itsflyable at 10:23 AM on February 28, 2017


IANAD, but I am a lawyer who has handled medical negligence claims involving cases where hospital emergency departments failed to refer to an ENT specialist under similar factual settings.

The problem is that you may well cough that back up into your airway and block it with disastrous consequences.

It is not going to dissolve in your lung. It's not going anywhere until an ENT removes it or you cough it up. You may be able to successfully cough it up, or it may become lodged in your airway.

I'd be on my way to the emergency room if I was you.
posted by mygoditsbob at 11:16 AM on February 28, 2017 [8 favorites]


Yeah, if you manage to move the pill, there is a chance it won't just neatly see itself out. You could make it worse.
posted by delight at 11:19 AM on February 28, 2017


And you won't have time to calmly drive yourself to the hospital or even summon help because you will be choking.
posted by delight at 11:21 AM on February 28, 2017


The other reason that you want that out of there is that it will block some portion of your lung from air exchange and may lead to infection or other problems. Once you have a solid object in your lung, there is no exit except for it to come back up the way it went in.
posted by mygoditsbob at 11:57 AM on February 28, 2017 [1 favorite]


The method I use when I get food stuck in my airway is as follows:

1. Bend over so that your torso is parallel to the floor with your hands on your knees.
2. Facing the floor, perform a sort of vibrating cough (almost like you're clearing your throat continuously)

I recall learning this off a Youtube video. I had a piece of chewed bread go down the wrong way and even though I could breathe and talk I felt a nagging, distracting discomfort in my throat and upper chest. After a couple tries of following the throat-vibrating cough instructions (interspersed with feeling a tad bit foolish while performing it because it sounded like a sputtering engine cough-moan), the little piece of bread shot out of my mouth and I immediately felt relief.

I hope your problem goes away safely.
posted by Iron Carbide at 3:02 PM on February 28, 2017 [2 favorites]


Please update this so we know you're okay.
posted by AFABulous at 8:49 PM on February 28, 2017 [2 favorites]


all good, thanks everyone!
posted by j_curiouser at 9:42 AM on March 1, 2017 [3 favorites]


ps: walking about, coughing, drinking water. i imagine the tablet worked its way into the esophagus and got swallowed at some point. no immediate indication it happened, but it got better over a few hours.
posted by j_curiouser at 2:58 AM on March 2, 2017


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