Choking and Strangulation

Choking and Strangulation

Choking occurs when children cannot breathe normally because their airway is obstructed. This injury can be serious and even fatal. Small children who put things in their mouths are the most susceptible to this type of injury. Small stones, small pieces of bulk playground surfacing material, toy parts, and food are among the items that might cause a choking hazard.

Strangulation occurs when something is wrapped around a child’s neck and he/she can’t breathe so oxygen can’t get to the brain. Strangulation hazards are related to the design of play equipment, the maintenance of play equipment, supervision, and inappropriate play behavior.

Head and neck entrapments on play equipment are a hazard that could cause strangulation.1 Wearing bicycle helmets on a playground increases the size of the child’s head and the likelihood of a head entrapment.

A lack of proper inspection and maintenance of play equipment may allow entanglements such as projecting bolts, open “S” hooks, and drawstring gaps to exist and thus be a strangulation hazard.

Loose clothing and clothing with drawstrings that could catch on play equipment and become entangled can cause strangulation. Drawstring entanglement is a particular problem on slides. The force of gravity can cause strangulation before a child can get free of a neck drawstring caught in a gap at the top of a slide. Open or slightly open “S” hooks can also entangle children’s loose clothing as they play on swings.

Cords such as jump ropes, dog leashes, or rope swing supports also have the potential for strangulation and should not be left attached or near playground equipment. In Seattle, an 11 year old girl became entangled in a rope that was attached to a track ride to help kids who can’t reach the handhold. The rope wrapped around her neck. She was unconscious when found but revived by medics.2

Lack of supervision or inappropriate play is a hazard that is associated with strangulation hazards of older children. In recent years, the “Choking Game” where children either hold each other in choke holds or use a rope to cut off the supply of oxygen, has caused some near fatalities. Children playing this game have been found both in school yards3 and in unattended playgrounds.

Choking and strangulation are unintentional, preventable injuries with the proper playground maintenance and supervision.

  • 1. U.S. Consumer Product Safety Commission (CPSC) Publication #325-10, “Public Playground Safety Handbook,” 3.3.1, p. 15.
  • 2. “Girl Nearly Choked to Death in Playground Accident.” Komo News. < > 6 Feb. 2014.
  • 3. “Boy, 13, recovering after playground choking game goes wrong,” The Telegraph. <> 6 Feb. 2014.