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May 1, 1996

Reducing Choking Deaths in Children-Reply

Author Affiliations

Johns Hopkins School of Hygiene and Public Health Baltimore, Md

JAMA. 1996;275(17):1314. doi:10.1001/jama.1996.03530410027027

In Reply.  —One of the tools of injury control1 is the frequency-effectiveness diagram.2 When we place the various possible interventions for preventing choking deaths in small children proposed by Dr Rimell and colleagues,3 Mr Flynn, Dr Kerr, and us4 on a frequency-effectiveness diagram (Figure), we quickly see the probable effectiveness of each proposed treatment. Although Kerr's proposal is not necessarily aimed at the hazards involved in choking deaths, it could prevent ingestions, at least among those affluent enough to purchase such a system and diligent enough to use it, and strikes us as useful.Flynn's suggestion of educational campaigns is likely to be of limited value in the solution of the problem of childhood choking deaths. Educational campaigns are not all the same. Those that measurably eliminate some purchases of a hazardous product, such as purchases of balloons by parents of children younger than 3 years,