caa a22 4500 469050314 CHVBK 20180323132829.0 cr unu---uuuuu 170328e19920301xx s 000 0 eng 10.1007/BF02493418 doi (NATIONALLICENCE)springer-10.1007/BF02493418 Laryngologic aspects of bolus asphyxiation-bolus death [Elektronische Daten] [Bernhard Jacob, Carola Wiedbrauck, Jürgen Lamprecht, Wolfgang Bonte] Among 12,982 forensic autopsies, 78 cases of café coronary due to bolus impaction in the larynx (bolus death) were observed from 1947 to 1988. In all cases bolus material occluded the entry to the larynx; only once was a signular occlusion of the glottis observed. The bolus frequently extended into the mouth, trachea, and bronchial tree or esophagus. In all cases small amounts of aspirated material were observed in the deeper parts of the bronchial tree. The most commonly observed bolus was not masticated meat or a meat product. In adults and the elderly the bolus was often too large to pass the physiological narrowings of the hypopharynx. It was commonly lodged above the arytenoid cartilages. Forty-five of the bolus events were observed by bystanders. In 43 of the victims vital reactions were observed by bystanders or at the autopsy. This justifies the hope that many lives could have been saved had the right diagnosis and immediate therapy been initiated. The first step should be manual extraction or use of the Heimlich maneuver; in cases of failure of both attempts, immediate tracheotomy followed by hospitalization and bronchial lavage are indicated. Springer-Verlag New York Inc, 1992 Café coronary nationallicence Bolus death nationallicence Alcoholic intoxication nationallicence Deglutition nationallicence Deglutition disorders nationallicence Jacob Bernhard Institute of Legal Medicine, Heinrich Heine University Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Germany aut Wiedbrauck Carola Department of Ear Nose and Throat Diseases, Heinrich Heine University Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Germany aut Lamprecht Jürgen Department of Ear Nose and Throat Diseases, Heinrich Heine University Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Germany aut Bonte Wolfgang Institute of Legal Medicine, Heinrich Heine University Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Germany aut Dysphagia Springer-Verlag 7/1(1992-03-01), 31-35 0179-051X 7:1<31 1992 7 455 https://doi.org/10.1007/BF02493418 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02493418 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jacob Bernhard Institute of Legal Medicine, Heinrich Heine University Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Germany aut NATIONALLICENCE 700 1- Wiedbrauck Carola Department of Ear Nose and Throat Diseases, Heinrich Heine University Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Germany aut NATIONALLICENCE 700 1- Lamprecht Jürgen Department of Ear Nose and Throat Diseases, Heinrich Heine University Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Germany aut NATIONALLICENCE 700 1- Bonte Wolfgang Institute of Legal Medicine, Heinrich Heine University Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Germany aut NATIONALLICENCE 773 0- Dysphagia Springer-Verlag 7/1(1992-03-01), 31-35 0179-051X 7:1<31 1992 7 455 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer