Community Services

Choking happens when someone's airway suddenly gets blocked, either fully or partly, so they can't breathe or breathe properly. They will have needed assistance to clear.

If there are any other signs of swallowing problems e.g. coughing on food/ drink at other times, pouching, chest infections, please submit an SLT referral and whilst waiting for assessment:

1. Ensure supervision with all food
2. Ensure staff follow feeding safely routines and risk assessments/ care plans updated.
3. Implement coughing monitoring charts
4. Weigh the patient and calculate their MUST score – Follow the Food First approach and consider dietetic referral if this is indicated.
5. Whilst waiting for SLT consider the least restrictive diet modification – see the level 3 - 7 diet sheets available on this page. Ensure mental capacity act legislation is followed and the relevant documentation is updated.

Is it a one-off choking episode with no other signs of swallowing problems or are you unsure if they have any other problems? In this case:

1. Provide supervision with all meals
2. Follow feeding safely routines and provide support at mealtimes to chop up food/ slow down rate of eating if needed. Click here for more information
3. Implement coughing monitoring charts and monitor over next week. If no other swallowing issues noted and problems resolved by your action, then SLT referral likely not needed. Update your care plan to include any support needed going forward e.g. supervision, cutting up food etc

If other problems are seen, please submit an SLT referral along with the completed coughing monitoring charts.

Please submit an SLT referral ASAP if the patient is coughing on food and has repeated chest infections, coughing at all meal times, or regularly coughing resulting in at least one choking episode requiring assistance. Whilst waiting for assessment:

1. Ensure supervision with all food
2. Ensure staff follow feeding safely routines and risk assessments/ care plans updated.
3. Implement coughing monitoring charts
4. Weigh the patient and calculate their MUST score – Follow the Food First approach and consider dietetic referral if this is indicated.
5. Whilst waiting for SLT consider the least restrictive diet modification – see the level 3 - 7 diet sheets available on this page. Ensure mental capacity act legislation is followed and the relevant documentation is updated.

For all other concerns complete steps 1-4:

1. Review charts. If the problem is resolved by feeding safely routines, ensure care plans reflect this.  SLT assessment is not needed in this case.
2. Check that coughing is related to eating and drinking. If not, then arrange GP review as SLT input likely not needed.
3. If ongoing issues refer to SLT, sending copies of monitoring charts and up to date weight and MUST score.
4. Whilst waiting for SLT consider the least restrictive diet modification – see the level 3 - 7 diet sheets available on this page. Ensure mental capacity act legislation is followed and the relevant documentation is updated.