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.

RED FLAG FOR REFERRAL:  Are there 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. Weight and MUST score – Follow Food First approach and consider dietetic referral if this is indicated.
5. Whilst waiting for SLT consider least restrictive diet modification – see IDDSI textures ensuring mental capacity act legislation is followed and documentation 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.

RED FLAG FOR REFFERRAL: Coughing on food & Repeated chest infections Coughing seen on all food Regular coughing episodes on food plus a choking episode requiring assistance

Please submit an SLT referral asap 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. Weight and MUST score – Follow Food First approach and consider dietetic referral if this is indicated.
5. Consider least restrictive diet modification – see section on decision making

For all other concerns complete steps 1-4:

1. Review charts. If problem resolved by feeding safely routines, ensure care plans reflect this.  SLT assessment 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 to assess consider least restrictive diet modification – see IDDSI textures ensuring mental capacity act legislation is followed and documentation updated.