Who would have thought something as innocent and simple as a rice cake could cause several deaths each year in Japan. Sadly this usually coincides with happy celebrations, when families eat the cakes together to mark the start of a new year.

Japanese media reported a peak of nine deaths in 2014 to 2015 with hundreds more people rushed to hospital. Some basic first aid knowledge can go a long way, and help to clear the cake from a casualty’s airway.

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What are They?

Japanese rice cakes are often referred to as ‘mochi’s and are essentially small buns of soft and chewy rice. Mochi’s are formed by first steaming the rice and then pounding and mashing it using traditional techniques.

Finally they are molded into their famous ‘mochi’ shape and then baked in the oven. Generations of Japanese people relate to the cake and associate it with their family's new years celebrations.

Who’s at Risk?

The Japanese rice cakes are not necessarily any riskier than the type of cakes we eat on UK shores. However vulnerable groups such as the elderly and young children may not chew the cakes properly. When swallowed the cake can become lodged in the throat, and cause the casualty to suffocate.

Helpful Hint - The advice with Japanese rice cakes is to chew, chew and chew more before swallowing to avoid a choking incident.

What to Do in an Emergency

If you are at a party, at the dinner table or out in a restaurant, look out for these key signs of choking:

  • Inability to speak;
  • Making strange ‘gurgling’ noises;
  • Eyes watering;
  • Panicky and distressed state.

Keep calm when you have ascertained that someone is choking and adopt the following four step protocol

  1. Encourage the casualty to cough;
  2. If choking, deliver five sharp back blows in the middle of the shoulder blades;
  3. If still choking deliver five abdominal thrusts (formally heimlich manoeuvre);
  4. Repeat steps 2-3 for 3 cycles. Then call for an ambulance, and continue with the cycles until they arrive.

Remember - Choking is easily treatable and nearly all cases can be resolved with the combination of back blows and thrusts. When in doubt contact the emergency services.