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Choking

Choking, also known as foreign body airway obstruction (FBAO), is a phenomenon that occurs when breathing is impeded by a blockage inside of the respiratory tract. An obstruction that prevents oxygen from entering the lungs results in oxygen deprivation. Although oxygen stored in the blood and lungs can keep a person alive for several minutes after breathing stops, choking often leads to death.

Around 4,500 to 5,000 choking-related deaths occur in the United States every year. Deaths from choking most often occur in the very young (children under three years old) and in the elderly (adults over 75 years). Foods that can adapt their shape to that of the pharynx (such as bananas, marshmallows, or gelatinous candies) are more dangerous. Various forms of specific first aid are used to address and resolve choking.

Choking is the fourth leading cause of unintentional injury death in the United States. Many episodes go unreported because they are brief and resolve without needing medical attention. Of the reported events, 80% occur in people under 15 years of age, and 20% occur in people older than 15 years of age. Worldwide, choking on a foreign object resulted in 162,000 deaths (2.5 per 100,000) in 2013, compared with 140,000 deaths (2.9 per 100,000) in 1990.

Signs and symptoms
Choking victims may present very subtly, especially in the setting of long term foreign body aspiration. Cough is seen in 80% of foreign body aspiration cases, and shortness of breath is seen in 25%. People may be unable to speak, attempt to use hand signals to indicate they are choking, attempt to force vomiting, or clutch at their throat.

History of episode
An observed or recalled episode of choking, with sudden onset of any of the below respiratory and skin signs and symptoms while eating or handling small objects, is seen in around 90% of choking episodes. Initial episodes typically last seconds to several minutes, but can be followed by symptom improvement that can be mistaken as resolution.

Respiratory
Initial respiratory symptoms can include involuntary cough, gurgling, gagging, shortness of breath, labored breathing, or wheezing. Children often present with excessive drooling and stridor (high pitched breathing sounds). Classic triad of choking symptoms in children is coughing, wheezing, and diminished breath sounds, however, a 10-year review showed that this grouping of symptoms was present together in only about 60% of patients.

Loss of consciousness may occur if breathing is not restored. In the setting of lower airway aspiration, patients may develop pneumonia like symptoms such as fever, chest pain, foul smelling sputum, or blood in sputum (hemoptysis). In the case of long term foreign body aspiration, patients may present with signs of lobar pneumonia or pleural effusion.

The time a choking victim is still alive without brain damage can vary, but typically brain damage can occur when the patient remains without air for approximately three minutes (it is variable). Death can occur if breathing is not restored in six to ten minutes (varies depending on the person). However, life can be extended by using cardiopulmonary resuscitation for unconscious victims of choking (see more details further below).

Skin
The face could turn blue (cyanosis) from lack of oxygen if breathing is not restored. Cyanosis may also be seen on the fingertips. In a healthy child or adult, this sign is highly sensitive, but is only observed in 15-20% of choking episodes.

Causes
Choking occurs when a foreign body blocks the airway. This obstruction can be located in the pharynx, the larynx, trachea, or lower respiratory tract. The blockage can be either partial (insufficient air passes through to the lungs) or complete (complete blockage of airflow).

Foods that are small, round, or hard pose a high risk of choking. Examples include hard candy, chunks of cheese or hot dogs, nuts, grapes, marshmallows, and popcorn.

Among children, the most common causes of choking are food, coins, toys, and balloons. In one study, peanuts were the most common object found in the airway of children evaluated for suspected foreign body aspiration. Small, round non-food objects such as balls, marbles, toys, and toy parts are also associated with a high risk of choking death because of the potential to completely block a child's airway. Children younger than age three are especially at risk of choking due to lack of fully developed chewing habits, and the tendency to insert object in their mouth as they explore the environment. Because a child's airway is smaller in diameter than that of an adult's, smaller objects can more often cause airway obstruction in children. Additionally, infants and young children generate a less forceful cough than adults, so coughing may not be as effective in relieving airway obstruction.

Risk factors of foreign body airway obstruction for people of any age include the use of alcohol or sedatives, procedures involving the oral cavity or pharynx, oral appliances, or medical conditions that cause difficulty swallowing or impair the cough reflex. Conditions that can cause difficulty swallowing and/or impaired coughing include neurological conditions such as stroke, Alzheimer's disease, or Parkinson's disease. In older adults, risk factors also include living alone, wearing dentures, and having difficulty swallowing. Children and adults with neurological, cognitive, or psychiatric disorders are at an increased risk of choking and may experience a delay in diagnosis because there may not be a known history of a foreign body entering the airway.

Choking on food is only one type of airway obstruction; others include blockage due to tumors, swelling and inflammation of the airway tissues (from organic foreign bodies or another reason), and compression of the laryngopharynx, larynx, or vertebrate trachea in strangulation. Foreign bodies can also enter the reparatory tract through the chest wall, such as in the setting of a gunshot injury.

Diagnosis
Recognition and diagnosis of choking primarily involves identification of the signs and symptoms like coughing and wheezing (see Signs and Symptoms). Immediate recognition of the symptoms is important, but based on the short length of some episodes, diagnosis during the first 24 hours only occurs in 50–60% of cases.

After the initial episode, choking can lead to an obstruction of the airway that prompts further diagnostic steps. For choking episodes that require emergent evaluation by a doctor, several tools can be used for diagnosis, each with their advantages and drawbacks.

Imaging and visualization methods

 * Bronchoscopy
 * According to the American Heart Association, bronchoscopy is a reliable method used to visualize the cause of choking when not resolved via oxygen and supportive care. Bronchoscopy also is a crucial tool in foreign body removal after supportive care has been provided and the person who is choking is stable. However, bronchoscopy is an invasive form of imaging and intervention in comparison to the below diagnostic tools, and requires sedation to perform.

 * X-ray
 * An X-ray uses high-frequency electromagnetic radiation to visualize the human body. In the case of choking, a chest X-ray is obtained to visualize the lungs and upper airway. However, many objects do not show up on X-ray (radiolucent). About 10% objects are radio-opaque and can be visualized using X-ray. X-rays are more accessible than other imaging modalities but expose a person to radiation. In cases where X-ray is inconclusive, fluoroscopy may be able to demonstrate radiolucent or smaller foreign bodies. Chest fluoroscopy is a real-time X-ray image (sometimes referred to as an X-ray movie) to view breathing and coughing.

 * Computerized tomography (CT)
 * A CT scan uses a tube with multiple X-ray machines to build a 3D image from 2D X-ray images of multiple cross-sections. Radiolucent objects can be better captured on CT than X-ray. Additionally, modern imaging analysis software allows for airway reconstruction following a chest CT, creating a model of the airway network in the lungs that can better visualize the exast location of a foreign body. Since a CT is multiple X-rays, the exposure to radiation is significantly greater.

 * Magnetic resonance imaging (MRI)
 * An MRI scan uses radio-frequency pulse under a magnetic field to create a high-resolution image of the body. MRIs can detect foreign bodies with higher accuracy than X-ray or CT. MRI does not expose the person to radiation. Drawbacks of MRI include claustrophobia and high cost. For children, sedation may be required to undergo MRI imaging, which is an increased risk when the airway is already potentially compromised.

Treatment
Airway management is used to restore a person's ventilation which consists of severity assessment, procedural planning, and may consist of multiple treatment modalities to restore airway.

Treatments will vary based on severity and stage of airway blockage. In basic airway management, treatment generally consists of anti-choking first aid techniques, such as the Heimlich maneuver. In advanced airway management, complex clinical methods are used.

Basic treatment (first aid)
Basic treatment of choking includes several non-invasive techniques to help remove foreign bodies from the airways.

General strategy: "five and five"
For a conscious choking victim, most institutions such as the American Heart Association, the American Red Cross and the NHS, recommend the same general protocol of first-aid: encouraging the victim to cough, followed by hard back slaps (as described forward). If these attempts are not effective, the procedure continues with abdominal thrusts (the Heimlich maneuver) or chest thrusts if the victim cannot receive abdominal pressure (as described forward).

If none of these techniques are effective, protocol by various institutions recommend alternating the series of back slaps and series of thrusts (these on the abdomen or chest, depending on the victim), 5 times of each technique and repeat ("five and five").

This procedure has modifications for infants (babies under 1 year-old), for the people with problems in the belly as the pregnant or very obese people, for the disabled victims in wheelchair, for the victims that lay on the bed but are unable to sit down, and for the victims that lay on the floor but are unable to sit down.

In scenarios when the first aid procedures are not resolving the choking, it is necessary to call to emergency medical services, but administration of first aid should be continued until they arrive.

Choking can change the colour in the victim's faces due to lack of oxygen. If they lose consciousness and fall to the ground, it is recommended to avoid panic and begin the appropriate anti-choking resuscitation for unconscious victims or unconscious babies (under 1 year-old).

Each one of the techniques in the first aid protocol against choking are detailed below:

Cough
If the choking victim is conscious and can cough, the American Red Cross and the Mayo Clinic recommend encouraging them to stay calm and continue coughing freely.

Back blows (back slaps)
Many associations, including the American Red Cross and the Mayo Clinic, recommend the use of back blows (back slaps) to aid a choking victim. This technique is performed by bending the choking victim forward as much as possible, even trying to place their head lower than the chest, to avoid the blows driving the object deeper into the person's throat (a rare complication, but possible). The bending is in the back, while the neck should not be excessively bent. It is convenient that one hand supports the victim's chest. Then the back blows are performed by delivering forceful slaps with the heel of the hand on the victim's back, between the shoulder blades.

The back slaps push behind the blockage to expel the foreign object out. In some cases, the physical vibration of the action may cause enough movement to clear the airway.

Abdominal thrusts (Heimlich maneuver)
Abdominal thrusts are performed with the rescuer embracing the belly of the choking victim from behind. Then, the rescuer closes their own dominant hand, grasps it with the other hand, and presses forcefully with them on the area located between the chest and the belly button of the victim, in a direction of in-and-up. This method tries to create enough pressure upwards to expel the object that obstructs the airway. The strength is not focused directly against the ribs, to avoid breaking them. If the first thrust does not solve the choking, it can be repeated several times.

The use of abdominal thrusts is not recommended for infants under 1 year of age due to risk of causing injury, so there are adaptations for babies (see more details further below), but a child that is too big for the babies' adaptations would require normal abdominal thrusts (according to the size of the body). Besides, abdominal thrusts should not be used when the victim's abdomen presents problems to receive them, such as pregnancy or excessive size; in these cases, chest thrusts are advised (see more details further below).

Although it is a well known method for choking intervention, the Heimlich Maneuver is backed by limited evidence and unclear guidelines. The use of the maneuver has saved many lives but can produce deleterious consequences if not performed correctly. This includes rib fracture, perforation of the jejunum, diaphragmatic herniation, among others.

Chest thrusts
When abdominal thrusts cannot be performed on the victim (serious injuries, pregnancy, or belly size that is too large for the rescuer to effectively perform abdominal thrust technique), chest thrusts are advised instead.

Chest thrusts are performed with the rescuer embracing the chest of the choking victim from behind. Then, the rescuer closes the own dominant hand and grasps it with the other hand. This can produce several kinds of fists, but any of them can be valid if it can be placed on the victim's chest without sinking a knuckle too painfully. Keeping the fist with both hands, the rescuer uses it to press forcefully inwards on the lower half of the chest bone (sternum). The pressure is not focused on the very endpoint (named xiphoid process) to avoid breaking it. When the victim is a woman, the zone of the pressure of the chest thrusts would normally be above the level of the breasts. If the first thrust does not solve the choking, it can be repeated several times.

Anti-choking devices
Since 2015, several anti-choking devices were developed and released to the market. They are based on a mechanical vacuum effect, without a power source. Most use an attached mask to make a vacuum from the patient's nose and mouth. The current models of anti-choking devices are quite similar: a direct plunger tool (LifeVac), and a vacuum syringe (backward syringe) that also keeps the tongue in place by inserting a tube in the mouth (Dechoker). Both of them have received certification, and they have been reported to be effective in real cases. Other mechanical models are in development, such as Lifewand, which creates a vacuum by direct pressure against the patient's face.

A 2020 systematic review of the effectiveness of the three devices listed discovered "a more detailed review of the studies demonstrated a very low certainty of evidence for its use", and concluded that "there are many weaknesses in the available data and few unbiased trials that test the effectiveness of anti-choking suction devices resulting in insufficient evidence to support or discourage their use. Practitioners should continue to adhere to guidelines authored by local resuscitation authorities which align with ILCOR recommendations."

Some anti-choking devices like Act Fast Anti Choking Trainer are used as training devices by healthcare providers as well as schools in CPR training courses.

Unconscious victims
A choking victim who becomes unconscious must be gently caught before falling and placed lying face-up on a surface. That surface should be firm enough (it is recommended placing a layer of something on the floor and laying the victim above).

A rescuer can then ask for any of the known anti-choking devices that is available, and use it on the unconscious victim. After that, the obstruction would be dislodged, but it could remain into the mouth, which needs a manual removal. If the unconscious victim cannot breath then, or stays in a cardiac arrest, it will require to perform a normal cardiopulmonary resuscitation (CPR), as described below, but only alternating the 30 compressions and the two rescue breaths.

Emergency medical services must be called, if this has not already been done.

It can be also convenient that any rescuer asks for a defibrillator around (an AED, as those devices are very common today), just in case it can be necessary to treat the victim's heart.

Anyway, a choking victim that is already unconscious needs to receive (even with no more delay) an anti-choking cardiopulmonary resuscitation (CPR) for unconscious adults and children. It is not valid for infants less than one year old, who require a special adaptated CPR for unconscious babies (described further below).

The anti-choking cardiopulmonary resuscitation (CPR) for unconscious adults and children is quite similar to any other CPR, but with some modifications:

In a first step, a series of 30 chest compressions are applied on the lower half of the sternum (the bone that is along the middle of the chest from the neck to the belly) at an approximate rhythm of nearly 2 per second.

After that series, the rescuer looks for the obstructing object and, if it is already visible, the rescuer makes a try to extract it, usually by using a finger sweeping (hopefully from the mouth). Normally, the object would be a food bolus (and not the epiglottis, a cartilaginous flap of the throat). It is also possible to try to extract it when it is deeper and not visible, always carefully: using the fingers to take it, or lifting the victim's chin to form a straight way to the throat while the victim is face up (face down in case of the victim's tongue obstructs too much, or on a side with a base under the head) and then grasping or sweeping the stuck object with tools: thin kitchen tweezers, scissors (these used with care), forks and spoons (in a reverse position: introducing their handle) or even a toothpick (if other instruments were too much big for the case); but, anyway, the current protocols do not recommend extracting the obstructing object if it is not visible (a blind extraction), because of the risk to sink it deeper by accident, and because the compressions could move the object outside by themselves (in some cases). Moreover, if any removal is tried and is taking too much time, it may require alternating it with the chest compressions at some moments, without hindering to the extraction. And, whether the object has been found and removed in this step or not, the CPR procedure must pass to the next step and continue until the victims can breathe by themselves or emergency medical services arrive.

In the next step of the CPR, the rescuer applies a rescue breath, pinching the victim's nose and puffing air inside of the mouth. Rescue breaths would usually fail while the obstructing object is blocking the entrance of air. Anyway, it is recommended, additionally, tilting the victim's head up and down, to reposition it trying to open an entrance for the air, and then giving another rescue breath. After the rescue breaths, this resuscitation returns to the 30 initial compressions, in a cycle that repeats continually, until the victim regains consciousness and breathes, or until the object is extracted but a defibrillation is needed to solve a cardiac arrest (read below).

Defibrillation can also be needed, because an unconscious victim of choking can suffer a cardiac arrest at any moment, due to several possible causes. So it is convenient to ask around for a defibrillator (AED device), for trying a defibrillation on a victim that remains in cardiac arrest after having extracted the stuck object (if it has been extracted, and only after that). Those defibrillators are easy to use, as they emit their instructions with voice messages.

Finger sweeping
It is crucial to avoid blindingly sweeping the airway unless there is direct visualization of the airway – in fact, these procedures are advised only to be performed in more controlled environments such as an operating room. In unconscious choking victims, the American Medical Association has previously advocated sweeping the fingers across the back of the throat to attempt to dislodge airway obstructions. Many modern protocols suggest other treatment modalities are superior. Red Cross procedures also advise rescuers not to perform a finger sweep unless an object can be clearly seen in the victim's mouth to prevent driving the obstruction deeper into the victim's airway. Other protocols suggest that if the patient is conscious they will be able to remove the foreign object themselves, or if they are unconscious, the rescuer should place them in the recovery position to allow the drainage of fluids out of the mouth instead of down the trachea due to gravity. There is also a risk of causing further damage (inducing vomiting, for instance) by using a finger sweep technique. There are no studies that have examined the usefulness of the finger sweep technique when there is no visible object in the airway. Recommendations for the use of the finger sweep have been based on anecdotal evidence.

Infants (babies under 1 year-old)
The majority of choking injuries and fatalities occurs in children aged 0–4, highlighting the importance for widespread dissemination of the appropriate anti-choking techniques for these age groups. In fact, it has been shown that increased parental education may decrease choking rates among children.

For infants under 1 year-old, the American Heart Association recommends adapted procedures. The size of the children's body is the most important aspect in determining the correct anti-choking technique. So children who are too large for the babies' procedures require the normal first aid techniques against choking.

First aid for infants alternates a special cycle of back blows (five back slaps) followed by chest thrusts (five adapted chest compressions). In the back blows maneuver, the rescuer slaps on the baby's back. It is recommended that the baby receive them being slightly leaned upside-down on an inclination. There exist several ways to achieve this:

According to a widely propagated modality: the rescuer sits down on a seat with the baby, and supports the baby with a forearm and its respective hand. The baby's head must be carefully held with that hand (approximately by the face), and kept in a normal position, facing forward, not inclinated. Then the baby's body can be leaned forward upside-down along the rescuer's thighs, and receive the slaps.

As an easier alternative: the rescuer can sit on a bed or sofa, or even the floor, carrying the baby. Next, the rescuer should support the baby's body on the own lap, to lean the baby a bit upside-down at the right or the left of the lap. The baby's head must be in a normal position, facing forward, frontally, and not inclinated. It is always convenient that the baby's chest is supported against something. Then the rescuer would slap the back of the baby.

If the rescuer cannot sit down: at least it is possible to attempt the manoeuver at a low height and over a soft surface. Then the rescuer would support the baby with a forearm and the hand of that side, holding carefully the baby's head with that hand (approximately by the face, but always trying that the baby's head keeps in a normal position, facing forward, not inclinated). The baby's body would be leaned upside-down in that position to receive the slaps. In situations with rescuers who cannot do all of that (as rescuers with disabilities and others), they can still try the normal back blows, supporting the baby's chest with one hand, bending the baby's body, and then giving firm slaps with the other hand.

In the chest thrusts manoeuver, the baby's body is placed lying face up on a surface (it can be the rescuer's thighs, lap or forearm). Then, the rescuer does the compressions pressing with only two fingers on the lower half of the bone that is along the middle of the chest from the neck to the belly (on the chest bone, named sternum, on its part that is the nearest to the belly). Abdominal thrusts are not recommended in children less than one year old because they can cause liver damage.

The back blows and chest thrusts are alternated in cycles of five back blows and five chest compressions until the object comes out of the infant's airway or until the infant becomes unconscious.

If choking is unresolved despite these rescue attempts, it is vital that somebody calls to the emergency medical services and continue first aid until they arrive. An infant can fall unconscious soon, then an anti-choking resuscitation for infants is required (read next).

Unconscious infants
An unconscious infant has to be placed face-up on a firm and horizontal surface (as the floor). The baby's head must be in a straight position, facing frontally, because tilting it too much backwards can close the access to the trachea in infants.

A rescuer can then ask for any of the known anti-choking devices, and try it on the unconscious baby. There can be difficulties because of the little size of the infant. The obstruction can be dislodged, but remaining into the mouth, which would need a manual removal. If the baby cannot breath then, or stays in a cardiac arrest, the rescuer must perform a normal cardiopulmonary resuscitation (CPR), as it is described below, but only alternating the 30 compressions and the 2 rescue breaths.

Emergency medical services must be called, if this has not been done yet.

It can be also convenient that any rescuer asks for a defibrillator near (an AED, as those devices are very common today), just in case it is necessary to treat the baby's heart.

Until emergency services arrive, the American Heart Association recommends starting (even with no more delay) an anti-choking cardiopulmonary resuscitation (CPR) adaptive to infants less than one year old (described below). It is a cycle of resuscitation that alternates compressions and rescue breaths, like in a normal CPR, but with some differences: The rescuer begins by making 30 compressions, pressing with only two fingers on the lower half of the bone that crosses the middle of the chest from the neck to the belly (on the chest bone, named sternum, on its part that is the nearest to the belly), at an approximate rhythm of nearly 2 per second.

At the end of the round of compressions, the rescuer looks into the mouth for the obstructing object. And, if it is already visible, the rescuer makes a try to extract it (usually using a finger sweep). The rescuer must not confuse a foreign object with the epiglottis: a cartilaginous flap of the throat. It is possible to try to extract the object without seeing it, always carefully: taking it with the fingers, or using a toothpick (maybe, because almost any other tool would be too wide for a baby), but the current protocols do not recommend extracting the object if it is not visible (a blind extraction), because of the risk to sink it deeper by accident, and because the compressions could move the object outside by themselves (in some cases). A rescuer that already knows that the choking object is a bag (or similar) does not need to see the object before trying to extract it (because there is no risk of sinking it much deeper, and it is easy to detect by using the touch carefully). Anyway, if any removal is tried and takes too much time, it may require alternating it with the chest compressions at some moments, without hindering to the extraction. And, being the object extracted or not in this step, this CPR procedure must pass to the next action and continue until the babies can breathe by themselves or emergency medical services arrive.

In the next step of the CPR, the rescuer makes a rescue breath, covering the baby's mouth and nose simultaneously with the own mouth, and puffing air inside a first time. After that first rescue breath, it is recommended tilting the baby's head up and down, trying to open a space for the air in that manner, but leaving it approximately straight again, and then giving an additional rescue breath, for the second time. The rescue breaths usually fail while the object is still blocking, but then the rescuer has only to continue with the next step. Anyway, they can enter and reach the lungs, and then the chest of the baby would be seen rising. If a rescue breath arrived there, it is because the object has been moved to an unknown position that leaves some open space, so it can be useful making the next rescue breaths more softly to avoid moving the object to a new blocking position again, and, in case of those soft rescue breaths are not successful, increasing the strength of blowing in the next ones. The bodies of the babies are delicate, and, when the airway is not clogged, only a little strength in blowing is enough to fill their lungs. The baby's colour would improve after some successful rescue breaths. After the rescue breaths, the rescuer has to return to the 30 initial compressions, repeating the same resuscitation cycle again, continually, until the choking baby regains consciousness and breathe normally, or until the object is extracted but a defibrillation is needed to solve a cardiac arrest (read below).

Defibrillation can also be needed, because a choking infant that is already unconscious can suffer a cardiac arrest at any moment, due to several possible causes. So it is convenient to ask around for a defibrillator (AED device), for trying a defibrillation on a baby that remains in cardiac arrest after having extracted the stuck object (only if the object has been extracted). Those defibrillators are easy to use, as they emit their instructions with voice messages. One of the pads of the defribrillator (any of them) is attached to the baby's chest, and the other pad to the baby's back.

Pregnant or very obese people
Some choking victims cannot receive pressure on their bellies. Then, the American Heart Associated recommends substituting the abdominal thrusts for chest thrusts.

These victims can include: patients with serious injuries in the abdomen, pregnant women, and obese patients. However, in the case of the obese victims, if the rescuer is capable enough to effectively wrap their arms around the circumference of the victim's abdomen, it is possible to apply the normal first aid against choking, with abdominal thrusts (see details further above).

Chest thrusts are performed in a similar way to the abdominal thrusts, but with the fist placed on the lower half of the vertical bone that is along the middle of the chest (the chest bone, named sternum), rather than on the abdomen. As a reference, in women, the zone of pressure of the chest thrusts would be normally higher than the breasts. It is convenient to avoid placing the knuckles too painfully. Finally, strong inward thrusts are then applied.

The rest of the first aid protocol is the same, starting with asking the victim to cough freely, and then, if the victim cannot cough, the series of chest thrust are alternated with series of slaps on the back. Those back slaps are applied normally: bending forward the back of the victims and supporting their chest with one hand.

If choking remains unresolved, calling to emergency medical services is vital, but first aid should be continued until they arrive.

When the victims with abdominal problems become unconscious, they need the same anti-choking cardiopulmonary resuscitation procedure that is employed for other unconscious choking victims (see details further above).

Preventively, if a person with abdominal problems (as injury, pregnancy, or too much obesity) is present, placing an anti-choking device nearby can be useful.

In wheelchair victims
If the choking victim is a person in a wheelchair, the procedure is similar than in the case of the other victims. The difference is in trying to apply the techniques directly, while the victim is seated on the wheelchair.

Coughing should be encouraged first before applying the techniques. When the victim cannot cough, it is recommended alternating series of back blows and thrusts, as in other cases.

Back blows (back slaps) can be used after bending forward the back of the victim very much, and supporting the victim's chest with the other hand.

Abdominal and chest thrusts can also be used. To perform the abdominal thrusts, the rescuer must get behind the wheelchair. Then the rescuer can embrace the victim's abdomen from behind and above, leaning over the top of the wheelchair's backrest. If this is too difficult, the rescuer can get down and embrace from behind the victim's abdomen and the wheelchair's backrest all together. In narrow spaces that can not be opened, the position can be achieved by turning the victim to one side. Finally, the rescuer would grasp the own hand with the other, and place them between the chest and the belly button of the victim, and apply sudden pressures with them on that zone, in a direction of in-and-up. If the victim cannot receive abdominal thrusts (in cases as having serious injuries in the belly, pregnancy, and others), chest thrusts must be used instead. They are applied while the victim is in the wheelchair too, but making sudden inward pressures on the lower half of the breast bone (sternum), which is placed vertically along the middle of the chest. If the space is too narrow and impossible to widen, the abdominal or chest thrusts can be tried by turning the victim to one side.

Rescuers should alternate between back slaps and chest thrusts repeatedly until the choking is solved, as in other victims.

If choking remains unresolved, calling to emergency medical services is vital, but first aid should be continued until they arrive.

If a victim of choking in wheelchair becomes unconscious, anti-choking cardiopulmonary resuscitation (CPR) should be performed, which is exactly the same method for non-disabled victims of choking. Anyway, it can be noted that the victim needs to be removed from the wheelchair and laid face-up on an appropriated surface (not too hard or too soft, and it is possible to put a layer of something between the floor and the victim). While they are on their way, the rescuer should apply anti-choking cardiopulmonary resuscitation for unconscious victims (see details further above).

As a preventive measure, it is convenient to avoid placing patients with disabilities in a narrow and encased spaces at mealtimes, as more open spaces allow easier access for rescuers. Besides, placing an anti-choking device nearby is a common safety measure in environments.

On the bed but unable to sit up
If the choking victim is lying in bed, but is conscious and unable to sit up (such as in patients with disabilities or injuries), the first aid would be the same, but performed by sitting the patient on the edge of the bed.

Before adjusting the patient's position, the rescuer encourages the victim to cough freely and as forcefully as they can manage. The victim would do it better by turning to one side. When coughing is too difficult or impossible, the rescuer would sit the victim on the bed's edge, to make coughing easier or to apply the anti-choking manoeuvers (these are required if the victim cannot cough).

This can be achieved grasping the victim by the legs (behind of the knees, or by the calves or ankles) and rotating them until they are out of the bed. Next, the rescuer would sit the victim up on the edge, pulling the shoulders or arms (in the forearms or wrists). Then it is possible to apply the anti-choking manoeuvers from behind: series of back slaps (after leaning the victim forward, and supporting the chest with one hand) and series of abdominal thrusts (sudden compressions on the part of the victim's belly that is between the chest and the belly button, in a direction of in-and-up). When the victim cannot receive abdominal thrusts (in cases as having serious injuries in the belly, pregnancy, and others), the rescuer needs to change them for chest thrusts (sudden pressures inward on the lower half of the breast bone, which is placed vertically along the middle of the chest, from the neck to the belly).

When a rescuer cannot sit the victim up, it is possible to perform chest or abdominal thrusts frontally while the victim is lying on the bed (despite they would be less effective in that horizontal position). They are made by putting one hand on the top of the other and making with both of them strong pressures downwards on the lower half of the breast bone (the sternum), or in a downward-and-frontward direction between the chest and the belly button.

If choking remains unresolved, calling to emergency medical services is vital, but first aid should be continued until they arrive.

When the victims of choking in bed become unconscious, they need the same anti-choking cardiopulmonary resuscitation procedure that is employed for other unconscious choking victims (see details further above).

Preventively, it is important to know that eating while laying in bed increases the risk of choking. When a person with a disability or injury is present, a common measure of prevention is placing an anti-choking device at reach.

On the floor but unable to sit up
It is possible, though rare, that a choking victim would be laying on the floor but conscious. For example, someone having a disability that makes impossible to sit up and to keep standing up on the feet. If this is the case, the first aid is the same, but after sitting the victim on the floor.

Before adjusting the patient's position, the rescuer asks the victim to cough freely and with strength. The victim would cough better by turning to a side. If coughing is too difficult or impossible, the rescuer would sit the victim up, to make it easier or to apply anti-choking maneuvers (these are needed when the victim cannot cough).

A rescuer would sit the victim up by pulling the shoulders or arms (in the forearms or wrists). When the victim is sitting up, the rescuer can sit behind to apply the anti-choking manoeuvers: back slaps (after bending very much the back of the victim, and supporting the chest with one hand) and abdominal thrusts (sudden compressions in a direction of in-and-up, on the part of the victim's belly that is between the chest and the belly button). When victims cannot receive abdominal thrusts properly (as the seriously injured in the belly, and the pregnant women), the rescuer needs to change them for chest thrusts (sudden pressures inward on the lower half of the breast bone, which is placed vertically along the middle of the chest, from the neck to the belly).

In some situations it is impossible to sit the victim up, and then the rescuer can try one of the thrusts techniques to the front of their abdomen and chest (even though this is less effective, it could be the only option and therefore worth a try). Anyway, they can be made by putting one hand on the top of the other and using them to make strong pressures downwards on the lower half of the breast bone (the sternum), or downwards-and-frontwards on the abdomen (between the chest and the belly button).

If choking remains unresolved, calling to emergency medical services is vital, but first aid should be continued until they arrive.

If the victim is unconscious, it is needed the same anti-choking cardiopulmonary resuscitation procedure that is used in other unconscious choking victims (see details further above).

In the prevention of choking, it can be remembered the practice of placing an anti-choking device around people with disabilities.

Seizing victim
Seizing can occur for a multitude of reasons, but is common in those diagnosed with epilepsy. During a seizure, victims may experience strangulation or throat constriction during consciousness. The victim will not have control of their bodily functions and will need someone to create a safe area for them. One should clear a space where the victim can lay down and remove or loosen anything that is around their neck. Then one should turn them on their side as to help them breathe and to avoid potential choking on the saliva.

Self-treatment
First aid anti-choking techniques can be applied on oneself if others are not around to perform general first aid. This can include carrying an approved anti-choking device nearby (see above) or conducting first aid techniques on oneself, mainly by hand:

The most widely recommended manoeuver consists of positioning ones own abdomen over the border of an object: usually a chairback, but it could work on an armchair, railing or countertop, and then driving the abdomen upon the border, making sharp thrusts in an inwards-an-upwards direction. It is possible to place a fist or both fists between the chosen border and the belly, to increase the pressure of the manoeuver and make it easier (depending on the situation). It is also possible trying to fall on the edge, aiming to achieve more pressure in that way. Other variation of this consists in pressing one's own belly with an appropriated object, in an inwards-and-upwards direction.

Additionally, abdominal thrusts can be self-applied only with the hands. This is achieved by making a fist, grasping it with the other hand, and placing them on the area located between the chest and the belly button. Then the body is bent forward and the hands make strong compressions pressing in an inwards-an-upwards direction. One study concluded that the self-administered abdominal thrusts were as effective as those performed by another person.

When certain scenarios make it impossible for self treatment with abdominal thrust (serious injuries, pregnancy, or obesity), the self application of chest thrusts is recommended, although more difficult. This would be achieved by leaning the body forward, making a fist, grasping it with the other hand, and doing strong compressions inwards with both of them on the lower half of the chest bone (the sternum, the bone that crosses vertically the middle of the chest). It is convenient to relax the chest for a better reception. Other variation of this is the use of an appropriated object to press inwards in the same point, being equally convenient to receive the compressions when the chest is relaxed. Making attempts to cough, when it is possible, can also aid in clearing the airway.

Alternatively, multiple sources of evidence suggest applying the head-down (inverse) position. is a promising self treatment. To perform this manoeuver, put your hands on the floor and then place the knees on an upper seat (as on a bed, a sofa, or an armchair). Additional movements up or down can be attempted in this position.

Advanced treatment
There are many advanced medical treatments available to relieve choking or airway obstruction, including the removal of a foreign object with the help of a laryngoscope or bronchoscope. The use of any commercial approved anti-choking device, if it is available nearby, may be a more abrupt solution, but brief.

A cricothyrotomy may be performed as an emergency procedure when the stuck object cannot be removed. This is an intervention that involves severing a little opening in the patient's neck (between the thyroid cartilage and the cricoid cartilage, until reaching the trachea) and inserting there a tube to introduce air through it, bypassing the upper airways. Usually, this procedure is only performed by someone with knowledge about it and surgical skills, when the patient is already unconscious.

Prevention
The time to react to choking is quite brief, and choking can be lethal in the worst cases. For these reasons, it is convenient to prevent it, so that it does not happen.

General prevention
Choking usually happens by swallowing mouthfuls that are too large or too abundant, and have been badly chewed. To reduce this risk, split food in pieces of a moderate size, and chew them thoroughly before swallowing. Whenever a food can be chewed, it must be chewed, no matter whatever it is, even if it is very soft or gelatinous (such as creams, jellies and soft desserts).

It is useful to have some liquid near, so it can be drunk and help to finish swallowing (before choking has happened). To swallow correctly, it is recommended that the neck be in a normal position, with the head looking forward, and being sitting down or standing up (not lying down or too reclined).

Distractions and being absent-minded increase the risk of choking, as when one laughs or does an activity at the same time. For this reason, eating while under the effects of sleep (not completely awake) also increases the possibilities of choking. The danger also increases in the case of being under the influence of alcohol, drugs or some medications that affect to perception or reaction capabilities. Eating in mouthfuls require some care.

It is convenient to place anti-choking devices in public sites, events, risk areas and homes, to solve the cases of swallowing that can happen there.

Prevention for babies and children
All young children require care in eating, and they must learn to chew their food completely to avoid choking. Feeding them while they are running, playing, laughing, etc. increases the risk of choking. Caregivers must supervise children while eating or playing.

Pediatricians and dentists can provide information on various age groups to parents and caregivers about which food and toys are appropriate to prevent choking. It is recommended waiting until 6 months of age before introducing solid foods to infants (according to the American Academy of Pediatricians). Caregivers should avoid giving children younger than 5 years-old foods that pose a high risk of choking, such as hot dog pieces, bananas, cheese sticks, cheese chunks, hard candy, nuts, grapes, marshmallows, or popcorn. Later, when they are accustomed to these foods, it is recommended to serve them split into small pieces. Some foods as hot dogs, bananas, or grapes are usually split lengthwise, sliced, or both (being the cut into slices the main part for safety in many long-shaped foods).

Children readily put small objects into their mouths (deflated balloons, marbles, small pieces, buttons, coins, button batteries, etc.), which can lead to choking. A complicated obstruction for babies is choking on deflated balloons (including preservatives) or plastic bags. This also includes the nappy sacks, used for wrapping the dirty diapers, which are sometimes dangerously placed near the babies. To prevent children from swallowing things, precautions should be taken in the environment to keep dangerous objects out of their reach. Small children must be supervised closely and taught to avoid putting things into their mouths. Toys and games may indicate on their packages the ages for which they are safe. In the US, children's toy and product manufacturers are required by law to apply appropriate warning labels to their packaging, but toys that are resold may not have them. Caregivers can try to prevent choking by considering the features of a toy (such as size, shape, consistency and small parts) before giving it to a child. Children's products that are found to pose a choking risk can be taken off the market.

Parents, teachers, and other caregivers for children are advised to be trained in choking first aid and cardiopulmonary resuscitation (CPR).

Anticipatory guidance from pediatricians

As a part of well-visits, pediatricians provide education to parents and their children regarding their development. Included in these visits is anticipatory guidance, which provides advice to parents and children as primary prevention of disease and illness including choking. For example, for a child that is 7–9 months old, children start to develop a pincer grasp allowing them to reach for objects. The ability to place these objects in their mouths significantly increases choking risk.

Example anticipatory guidance for children 7–9 months old:

 * Infants should avoid moving when feeding like riding in a car or stroller. Infants should be sitting upright and remain still.
 * Infants should be supervised when feeding including children younger than 3 years old
 * Infants will try to feed themselves. Avoid foods such as grapes, popcorn, carrots, nuts, and hard candies. Difficult to swallow foods like peanut butter and marshmallows should be given with caution.
 * Specifically, toys like marbles, balls, balloons should not be given including children younger than 3 years old.

Regulations for children in the United States
Several laws and commissions are aimed at preventing choking hazards in children. Formed in 1972, alongside the passing of the Consumer Products Safety Act, the U.S. Consumer Product Safety Commission (CPSC) regulates consumer projects that may pose "unreasonable risk" of injury to its users. The Consumer Products Safety Act allowed the CPSC to ban or place warnings on objects that could harm consumers. A Small Parts Test Fixture (SPTF) is a cylinder measuring 2.25 inches long by 1.25 inches wide determines whether a choking hazarding warning will be placed on the product. Furthermore, in 2008, the Consumer Product Safety Improvement requires any advertisements or websites regarding sale of a product to display choking hazard warnings.

According to a 1991 study, warning labels are an effective preventive measure against choking accidents. Items that contain many parts may include pieces that are considered choking hazards. Labels on children's toys may state recommended age ranges, and other items may carry a warning to parents to keep them out of the reach of children. Warning labels are clearly placed and written, usually including an obvious image.

While products are protected, there are currently no Food and Drug Administration (FDA) regulations regarding food choking hazards.

Prevention for other groups at risk
Some population groups have a higher risk of choking, such as the elderly, persons with disabilities (physically or mentally), people under the effects of alcohol or drugs, people who have taken medications that reduce the ability to salivate or react, patients with difficulties in swallowing (dysphagia), suicidal individuals, people with epilepsy, and people on the autism spectrum. They may require more assistance to feed themselves, and it may be necessary to supervise them while they eat.

As the ability to eat is deteriorating, some problematic foods (such as hot dogs, sausages, bananas, or grapes) can be split into slices and, additionally, lengthwise (being the cut into slices the main part for safety in many long-shaped foods). People who are unable to chew properly should not be served hard food. In cases where a person is unable to safely eat, food can be given by feeding syringes.

People who have taken any medication that reduces saliva should not eat solid food until their salivation is restored.

title: Choking


text:
Sylvia Anderson

Sylvia Beatrice Anderson (25 March 1927 – 15 March 2016) was an English television and film producer, writer, voice actress and costume designer, best known for her collaborations with Gerry Anderson, her husband between 1960 and 1981. In addition to serving as co-creator and co-writer on their TV series during the 1960s and early 1970s, Anderson's primary contribution was character development and costume design. She regularly directed the fortnightly voice recording sessions, and provided the voices of many female and child characters. She also helped develop the shows and characters, in particular creating the iconic characters of Lady Penelope and Parker in Thunderbirds.

Early life
Anderson was born in Camberwell, London, England on 25 March 1927. Her father, Sidney Thomas, was a champion boxer, and her mother, Beatrice, a dressmaker.

After graduating from the London School of Economics with a degree in sociology and political science, she became a social worker. She emigrated to the United States to live with her first husband, Jack Brooks, an American golfer. While in America she worked as a journalist.

Career
Anderson returned to the United Kingdom in 1955 with her daughter. She joined the newly founded and short-lived Polytechnic Films as an office assistant in 1957. There, she met Gerry Anderson, an editor and director. That year, when Anderson and Arthur Provis created AP Films following Polytechnic's collapse, she joined them on the board of directors of the new company, alongside their colleagues John Read and Reg Hill.

Collaboration with Gerry Anderson
In 1957 AP Films was commissioned by writer Roberta Leigh to produce films based on her children's stories, including The Adventures of Twizzle and Torchy the Battery Boy. Sylvia Anderson worked on these projects as a production assistant. In late 1960 the couple married, and she developed a wider role in production duties.

The couple worked together as a team, co-writing and co-creating the first episode of a series then sharing the work according to their strengths. Gerry tended to specialise in special effects and hardware, and Sylvia in character, voices, costume, dialogue, and plotlines.

In this way, Anderson contributed plot development and voice work for a series of half-hour shows including Supercar, Stingray and Fireball XL5. The Supercar end titles credit her (as Sylvia Thamm) as the Dialogue Director, a task which she would also handle in other projects. However, she felt the half-hour format was insufficient to fully develop characters and stories, and she persuaded the team's TV producer Lew Grade to extend their shows to a full hour.

In the early 1960s, the Andersons co-created the series Thunderbirds, and Sylvia created the characters. She was aware that Grade intended to sell the show to American TV networks and wanted to make the show appealing to American audiences, hence she introduced the "British aristocrat" character of Lady Penelope, and Parker her "Cockney chauffeur".

Lady Penelope Creighton-Ward, an aristocratic fashionista who was an undercover agent, was to become one of her most popular characters; Anderson both created the character and provided her voice. AP Films puppet designer Mary Turner used Anderson as the template for the creation of the Lady Penelope puppets, a decision of which Anderson was not immediately aware. Interviewed by the Daily Mirror in 1968, Turner commented: "we wanted a glamorous blonde and [Anderson] was the obvious choice." In 1966 and 1968, Anderson produced two feature-length films based on the Thunderbirds story, Thunderbirds Are Go and Thunderbird 6.

She was co-creator with Gerry Anderson for the series UFO (1969-1970) on which she co-produced, was responsible for fashions on the show and did the majority of the casting.

The Andersons' creative partnership ended when their marriage broke down during the production of the first series of Space: 1999 in 1975. Gerry announced his intention to separate on the evening of the wrap party, following which Sylvia ceased her involvement with the company, which by this time had twice been renamed and was now called Group Three.

Talent scout and writing
In 1983 she published a novel titled Love and Hisses and in 1994 she reprised her voice role as Lady Penelope for an episode of Absolutely Fabulous. She worked as a London-based talent scout for HBO for 30 years.

Her autobiography, Yes M'Lady, was first published in 1991; in 2007, it was re-published as My FAB Years with new material to bring it up to date with the latest developments in her life, such as her role as a production consultant for the 2004 live-action film adaptation of Thunderbirds.

Of the film, Anderson commented, "I'm personally thrilled that the production team have paid us the great compliment of bringing to life our original concept for the big screen. If we had made it ourselves (and we have had over 30 years to do it!) we could not have improved on this new version. It is a great tribute to the original creative team who inspired the movie all those years ago. It was a personal thrill for me to see my characters come to life on the big screen." My FAB Years was re-released as a spoken CD, narrated by Anderson, in 2010.

Late career and charity work
In 2013, Anderson worked with her daughter Dee, a jazz singer, on a concept for a new TV series named The Last Station.

In 2015, Anderson briefly returned to the Thunderbirds universe, when she guest-starred in an episode of the reboot TV series, Thunderbirds Are Go, as Great Aunt Sylvia, a relative of Lady Penelope.

Anderson was also known for her charity work, particularly in support of Breast Cancer Care and Barnardo's.

Recognition
In 1966, Thunderbirds received the Royal Television Society Silver Medal.

In 2015, Anderson travelled to Italy to receive a Pulcinella Award in recognition of her career in television production.

Personal life and death
In 1946, Anderson married Jack Brooks, with whom she had a daughter, Dee. The marriage ended in divorce and in 1952 she married George Thamm, this marriage also ending in divorce. Her third marriage, in 1960, was to Gerry Anderson, with whom she had a son, Dr. Gerry Anderson Jr. (1967-2023), before divorcing Anderson in 1981.

Sylvia Anderson died on 15 March 2016 aged 88.

AP Films

 * The Adventures of Twizzle (1957–59) – production assistant
 * Torchy the Battery Boy (first series) (1960) – production assistant
 * Four Feather Falls (1960) – production assistant
 * Supercar (1961–62) – dialogue director, voice artist
 * Fireball XL5 (1962–63) – voice artist
 * Stingray (1964–65) – production assistant, voice artist
 * Thunderbirds (1965–66) – character development, voice artist

Century 21

 * Captain Scarlet and the Mysterons (1967–68) – character development, voice artist
 * Joe 90 (1968–69) – character development, voice artist
 * The Secret Service (1969) – character development, voice artist
 * UFO (1970–71) – costume designer

Group Three

 * The Protectors (1972–74) – writer
 * Space: 1999 (1975–77) – producer ("Year One")

ITV Studios and Pukeko Pictures

 * Thunderbirds Are Go (2015) – voice artist (as Great Aunt Sylvia)

Filmography

 * Crossroads to Crime (1960) – production assistant, uncredited acting role
 * Thunderbirds Are Go (1966) – co-writer, co-producer, voice artist
 * Thunderbird 6 (1968) – co-writer, co-producer, voice artist
 * Doppelgänger (1969) a.k.a. Journey to the Far Side of the Sun (US title) – co-writer, co-producer
 * Thunderbirds (2004) – production consultant

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Sylvia Anderson


text:
Gerry Anderson

Gerald Alexander Anderson (14 April 1929 – 26 December 2012) was an English television and film producer, director, writer and occasional voice artist, who is known for his futuristic television programmes, especially his 1960s productions filmed with "Supermarionation" (marionette puppets containing electric moving parts).

Anderson's first television production was the 1957 Roberta Leigh children's series The Adventures of Twizzle (1957–58). Torchy the Battery Boy (1960), and Four Feather Falls (1960) followed. Supercar (1961–62) and Fireball XL5 (1962–63) came next, both series breaking into the U.S. television market in the early 1960s. In the mid-1960s Anderson produced his most successful series, Thunderbirds. Other television productions of the period included Stingray, Captain Scarlet and the Mysterons and Joe 90.

Anderson also wrote and produced several feature films, including Doppelgänger (aka Journey to the Far Side of the Sun, 1969). Following a shift towards live-action productions in the 1970s, he had a long and successful association with media impresario Lew Grade and Grade's company ITC, continuing until the second series of Space: 1999.

After a lull in which a number of new series failed to materialise, Anderson began a new phase in his career the early 1980s, when nostalgia for his earlier Supermarionation series, prompted by Saturday morning re-runs in Britain and Australia, led to new commissions. Later projects included a 2005 CG remake of Captain Scarlet titled New Captain Scarlet. Anderson died in 2012.

Early life
Gerald Alexander Abrahams was born in the Elizabeth Garrett Anderson and Obstetric Hospital in Bloomsbury, London, and spent the early years of his life in Kilburn, and Neasden, London. He was educated at Kingsgate Infants School in Kilburn and Braintcroft Junior and Senior schools in Neasden, prior to winning a scholarship to Willesden County Grammar School. His parents were Deborah (née Leonoff) and Joseph Abrahams.

Anderson's Jewish paternal grandfather had the surname Bieloglovski. He fled from an area near the Poland–Russia border and settled in London; his name was changed to "Abrahams" by an immigration official upon his arrival in 1895. Anderson's Jewish mother Deborah changed the family name to "Anderson" in 1939.

At the start of the Second World War, Gerry Anderson's elder brother, Lionel, volunteered for service in the Royal Air Force (RAF); he was stationed in the United States for advanced training. Lionel often wrote letters to his family, and in one letter described a US Army Air Forces air base called Thunderbird Field, the name of which stayed in his younger brother's memory. Lionel was killed in action on 27 April 1944 when his de Havilland Mosquito was shot down over the Netherlands.

On 16 October 1952, Anderson married Betty Wrightman (1929–2021). They had two daughters, Linda (b. 1954) and Joy (b. 1957).

Television, film and military career
Anderson began his career in photography, earning a traineeship with the British Colonial Film Unit after the war. He developed an interest in film editing and moved on to Gainsborough Pictures, where he gained further experience. In 1947, he was conscripted for national service with the RAF, and was based at RAF Manston, an airfield near Margate. He served part of his time in air-traffic control.

Two incidents in his final year with the RAF had a profound effect on Anderson. The first occurred during an aircraft display on 18 September 1948 commemorating the Battle of Britain, when a Mosquito aircraft crashed on a road crowded with occupied cars; reports on the death toll ranged between twelve and 20 people. On another occasion, a Spitfire was coming in to land. It was only about 50 ft above the ground before the runway controller alerted the pilot to the fact the plane's undercarriage hadn't lowered. The pilot opened up the throttle and climbed away. As this was a moment Anderson always remembered, he found it all too easy to write about aircraft when he devised stories for Thunderbirds. After completing his military service, he returned to Gainsborough, where he worked until the studio was closed in 1950. He then worked freelance on a series of feature films.

In the mid-1950s, Anderson joined the independent television production company Polytechnic Studios as a director, where he met cameraman Arthur Provis. After Polytechnic collapsed, Anderson, Provis, Reg Hill and John Read formed Pentagon Films in 1955. Pentagon was wound up soon after and Anderson and Provis formed a new company, AP Films, for Anderson-Provis Films, with Hill and Read as their partners. Anderson continued his freelance directing work to obtain funds to maintain the fledgling company.

AP Films' first television venture was produced for Granada Television. Created by Roberta Leigh, The Adventures of Twizzle (1957–1958) was a series for young children about a doll with the ability to 'twizzle' his arms and legs to greater lengths. It was Anderson's first work with puppets, and the start of his long and successful collaborations with puppeteer Christine Glanville, special effects technician Derek Meddings and composer/arranger Barry Gray. It was Anderson's desire to move into live-action television.

The Adventures of Twizzle was followed by another low-budget puppet series with Leigh, Torchy the Battery Boy (1958–1959). Although the APF puppet productions made the Andersons world-famous, Anderson was always unhappy about working with puppets. He used them primarily to get attention from and a good reputation with TV networks, hoping to have them serve as a stepping stone to his goal of making live-action film and TV drama.

Supermarionation

During the production of The Adventures of Twizzle, Anderson started an affair with secretary Sylvia Thamm. Following his divorce from his first wife, Anderson married Thamm in November 1960.

AP Films' third series was the children's western fantasy-adventure series Four Feather Falls (1959–60). Provis left the partnership, but the company retained the name AP Films for several more years. Four Feather Falls was the first Anderson series to use an early version of the so-called Supermarionation process, though this term had yet to be used.

Despite APF's success with Four Feather Falls, Granada did not commission another series from them, so Anderson took up the offer to direct a film for Anglo-Amalgamated Studios. Crossroads to Crime was a low-budget B-grade crime thriller, and although Anderson hoped that its success might enable him to move into mainstream film-making, it failed at the box office.

By this time, APF was in financial trouble and the company was struggling to find a buyer for their new puppet series. They were rescued by a fortuitous meeting with Lew Grade, the Associated Television (ATV) boss who offered to buy the show. This began a long friendship and a very successful professional association between the two men.

The new series, Supercar, (1960–61) was developed by Gerry and Sylvia Anderson and Reg Hill based on a story written by Sylvia Anderson and marked several important advances for APF. Sylvia took on a larger role and became a partner in the company. The series was also the official debut of Supermarionation, the electronic system that made the marionettes more lifelike and convincing on screen. The system used the audio signal from pre-recorded tapes of the actors' voices to trigger solenoids installed in the heads of the puppets, making their lips move in synchronisation with the voices of the actors, and actresses.

One of Anderson's most successful ventures was inaugurated during the production of Supercar. The establishment of AP Films (Merchandising) Ltd, a separate company set up to handle the licensing of merchandising rights for APF properties, was headed by Keith Shackleton (not the wildlife artist and TV presenter of the same name), a longtime friend of Anderson's from their National Service days.

The next series by APF was the futuristic space adventure Fireball XL5 (1962). At the time it was the company's biggest success, garnering the honour of being the only Anderson series sold to an American TV network, NBC. Around this time, Anderson also saw his Supermarionation style attract imitators—most notably Space Patrol (US title: Planet Patrol) which used similar techniques and was made by several former employees and associates of Anderson, including Arthur Provis and Roberta Leigh.

After the completion of Fireball XL5, Lew Grade offered to buy AP Films. Although Anderson was initially reluctant, the deal eventually went ahead, with Grade becoming the managing director, and the Andersons, Hill, and Read becoming directors of the company.

Shortly after the buy-out, APF began production on a new marionette series, Stingray (1964), the first Supermarionation-based British TV series to be filmed in colour. For the new production APF moved to new studios in Slough. The new and bigger facilities allowed them to make major improvements in special effects, notably in the underwater sequences, as well as advances in marionette technology, with the use of a variety of interchangeable heads for each character to convey different expressions.

Thunderbirds
APF's next project for ATV was inspired by a mining disaster that occurred in West Germany in October 1963. This real-life drama inspired Anderson to create a new programme format about a rescue organisation, which eventually became his most famous and popular series, Thunderbirds (1965–1966). The dramatic title was inspired by the letter Anderson's older brother Lionel had written to his family during World War II.

Grade was very enthusiastic about the concept and agreed to back a series of 25-minute episodes (the same length as Stingray), so the Andersons scripted a pilot episode, "Trapped in the Sky", and began production. Anderson initially wanted actress Fenella Fielding to perform the voice of Lady Penelope, but Sylvia convinced her husband that she herself ought to play the role. Thunderbirds also marked the start of a long professional association with actor Shane Rimmer, who voiced Scott Tracy.

Production on Thunderbirds had been under way for several months when Grade saw the completed 25-minute version of "Trapped in the Sky". He was so excited by the result that he insisted that the episodes be extended to fifty minutes. With a substantial increase in budget, the production was restructured to expand episodes already filmed or in pre-production, and create new 50-minute scripts for the remainder. Grade and others were so convinced that Thunderbirds would be a success that a feature-film version of the series was proposed even before the pilot episode went to air. At this approximate time, APF was renamed Century 21 Productions.

After APF was renamed Century 21 Productions, it enjoyed its greatest success with Thunderbirds, and the series made the Andersons world famous. However, it was cancelled midway through the second series because Grade was unable to sell the show to an American network. Despite being wildly popular in the UK and abroad, Grade felt that without an American buyer, a full second series would fail to recoup its cost. It would later find moderate success in the United States through syndication.

During the production of Thunderbirds the Andersons' marriage began to come under increasing strain, and the company also had a setback when the feature film Thunderbirds Are GO surprisingly flopped. In later interviews, Anderson said that he considered divorce, but this was halted when Sylvia announced that she was pregnant. Their son, Gerry Anderson Jr., was born in July 1967.

By that time, production had started on a new series, Captain Scarlet and the Mysterons (1967), which saw the advent of more realistic marionette characters which, thanks to improvements in electronics which allowed miniaturisation of the lip-sync mechanisms, could now be built closer to normal human proportions.

Century 21's second feature film, Thunderbird 6, was also unsuccessful, and the problems were compounded by their next (and penultimate) Supermarionation series, Joe 90 (1968). This series returned to more 'kid-friendly' territory, depicting the adventures of a young boy who is also a secret agent and whose scientist father uses a supercomputer called 'BIG RAT' which can 'program' Joe with special knowledge and abilities for his missions. Its relatively poor reception made it the last of the classic Anderson marionette shows.

Live-action work
Anderson's next project took the special effects expertise built up over previous TV projects and combined it with live action. Century 21's third feature film, Doppelgänger (1969) (released internationally as Journey to the Far Side of the Sun) was a dark, Twilight Zone-style sci-fi project about an astronaut who travels to a newly discovered planet on the opposite side of the sun, which proves to be an exact mirror-image of Earth, starring American actor Roy Thinnes. Although it was not a major commercial success, Doppelgänger was nominated for an Academy Award for its special effects.

Century 21's return to television was the abortive series The Secret Service, which this time mixed live action with Supermarionation. The series was inspired by Anderson's love of British comedian Stanley Unwin, who was known for his nonsense language, 'Unwinese', which he created and used on radio, in film and most famously on the 1968 Small Faces LP Ogdens' Nut Gone Flake. Despite Anderson's track record and Unwin's popularity, the series was cancelled before its first screening; Lew Grade considered that it would be incomprehensible to American audiences, and thus unsellable.

In 1969 the Andersons began production of a new TV series, UFO, Century 21's first full live-action television series. This sci-fi action-adventure series starred American-born actor Ed Bishop (who had also provided the voice of Captain Blue in Captain Scarlet & The Mysterons) as Commander Edward Straker, head of the secret defence organisation SHADO, set up to counter an alien invasion. UFO was more adult in tone than any of Anderson's puppet series, and mixed Century 21's signature futuristic action-adventure and special effects with serious dramatic elements. UFO was the last series made under the Century 21 Productions banner.

During production of UFO, Anderson was approached directly by Harry Saltzman (at the time co-producer of the James Bond film series with Albert "Cubby" Broccoli), and was invited to write and produce the next film in the series, which was to be Moonraker. Collaborating with Tony Barwick to provide the characterisation, whilst he himself focused on the action sequences, Anderson wrote and delivered a treatment to Saltzman. Nothing ultimately came of it, and Broccoli and Saltzman proceeded to make Diamonds Are Forever (1971) and Live and Let Die (1973) and, after co-producing 1974's Bond film, The Man with the Golden Gun, the Saltzman-Broccoli partnership dissolved. Offered £20,000 for the treatment, Anderson refused, fearing that if he accepted he would not be at the helm when it was made; the next Bond film to be made was 1977's The Spy Who Loved Me. (This film used only the title of the actual Ian Fleming novel.) Anderson started legal proceedings against Broccoli for plagiarism of story elements but withdrew the action shortly after, nervous of the legal might lined up against him. He relinquished the treatment, and received £3,000 in compensation. A film version of Moonraker was eventually produced in 1979, but did not involve any of Anderson's material.

By the time UFO concluded, the relationship between the Andersons had deteriorated. Although produced under the aegis of a new company, Group Three Productions (the three being both of the Andersons and Reg Hill), Anderson decided not to work with his wife on his next project, the ITC action series The Protectors. It was one of Anderson's few non-original projects. Lew Grade himself was heavily involved in the programme, and cast both the lead actors, Robert Vaughn and Nyree Dawn Porter. The production was difficult for Anderson, who clashed with the famously difficult Vaughn. There were also many logistical problems arising from the Europe-wide filming of the show, but it was very successful in both the UK and America and its theme song "Avenues and Alleyways" became a hit record in the UK for singer Tony Christie. It was also the first live-action series produced by Anderson to survive to a second season.

Space: 1999
Following The Protectors, Anderson worked on several new projects, none of which he was able to take into production. A proposed second series of UFO was not undertaken, and a return to marionettes in the television pilot for a series called The Investigator failed to find a buyer. Elements of the abandoned second series of UFO were eventually turned into what became the most expensive television series ever made at that time, Space: 1999.

Another futuristic science-fiction adventure, it was based on the premise that a huge thermonuclear explosion on the Moon's surface (caused by the storage of nuclear waste there) projected the Moon out of orbit and into interplanetary space. The series starred the American husband-and-wife actors Martin Landau and Barbara Bain, who had gained international fame in the TV series Mission: Impossible. They were cast at the insistence of Grade, and against Sylvia Anderson's strenuous objections.

The Andersons' marriage broke down during the first series of Space: 1999 in 1975; Gerry announced his intention to separate on the evening of the wrap party. Sylvia severed her ties with Group Three, and, to alleviate his financial plight, Anderson sold his share of the profits from the APF/Century 21 shows and their holiday home in Portugal to Lew Grade.

Between making the two series of Space: 1999, Anderson produced a one-off television special, The Day After Tomorrow (also known as Into Infinity), about two spacefaring families en route to Alpha Centauri, for an NBC series of programmes illustrating current scientific theory for popular consumption. While making this project, Anderson met Mary Robins (b. 1949), a secretary working at the studios; they began a relationship and were married on 11 April 1981.

Space: 1999 was successful enough that a second (and final) series went into production in 1976 with American producer Fred Freiberger brought in to replace Sylvia Anderson. Freiberger was known for producing the final season of the original Star Trek. Under Freiberger the series underwent a number of cast and cosmetic changes. Space: 1999 marked the end of Anderson's association with ATV.

By the late 1970s, Anderson's life and career were at a low point: he was in financial difficulty, found it hard to get work, and he experienced family difficulties.

1980s
By December 1980, Gerry and Sylvia's marriage was officially over, and they divorced. In 1981, episodes of many of Anderson's Supermarionation series were edited together as films, aired as Super Space Theatre. A number of similarly reedited feature-length productions were also syndicated and released on home video, such as Destination: Moonbase Alpha, a reedited version of a two-part Space: 1999 storyline. Some of these films were marketed in the US as part of a series of action-adventure videos featuring specially shot introductions by actress Sybil Danning.

In the early 1980s, Anderson formed a new partnership, Anderson Burr Pictures Ltd, with businessman Christopher Burr. The new company's first production was based on an unrealised concept devised by Anderson in the late 1970s for a Japanese cartoon series. Terrahawks marked Anderson's return to working with puppets, but rather than marionettes this series used a new system dubbed 'Supermacromation' which used highly sophisticated glove puppets—an approach inspired by the advances in this form of marionation made by Jim Henson and his colleagues.

It featured another reuse of the Captain Scarlet/UFO formula of a secret organisation defending against aliens. Terrahawks ran successfully from 1983 to 1986 in the UK but fell short of a four-year American syndication deal by one season when the show was cancelled. Terrahawks retains a cult following to this day. Anderson had claimed on record that he would rather forget the show.

Anderson hoped to continue his renewed success with a series called Space Police, a new show mixing live action and puppets. The Space Police name had already been registered by another company, so Anderson's programme eventually emerged in 1995 as Space Precinct. A pilot film had previously been made with Shane Rimmer, but it took almost ten years to get the concept to the screen. In the meantime, Anderson and Burr produced the cult stop-motion animated series Dick Spanner, which enjoyed many showings on the British Channel 4 in the late 1980s and early 1990s. It was the final project completed by Anderson Burr. Anderson then joined the Moving Picture Company as a commercials director, and provided special effects direction for the musical comedy Return to the Forbidden Planet.

1990s
The cult appeal of Thunderbirds and the other Supermarionation series grew steadily over the years and was celebrated by comedy and stage productions such as the hit two-man stage revue Thunderbirds FAB. In the early 1990s, ITC began releasing home video versions of the Supermarionation shows, and the profile of the shows was further enhanced by productions such as the Dire Straits music video for their single "Calling Elvis", which was made as an affectionate Thunderbirds pastiche (with Anderson co-producing), and by Lady Penelope and Parker appearing in a series of UK advertisements for Swinton Insurance.

In 1991 Gerry asked journalist and author Simon Archer to write his biography, following an interview by the latter for a series of articles for Century 21 magazine. In September that year in the UK, BBC2 began a repeat showing of Thunderbirds, which rivalled the success of its original run a generation before. This was also surprisingly the series' network television premiere, having never been shown nationally by ITV. It became so popular in Britain that toy manufacturers Matchbox were unable to keep up with the demand for the Tracy Island playset, leading children's show Blue Peter to broadcast a segment showing children how to construct their own for a second time, the first being during the original run. The fan base for the Anderson shows was now worldwide and growing steadily, and Anderson found himself in demand for personal and media appearances.

In response to this greater demand Anderson performed a successful one-man show in 1992, which Archer had written and constructed. Entitled An Evening with Gerry Anderson, it took the form of an illustrated lecture in which he talked about his career, and his most popular shows. He also made numerous media and personal appearances to tie in with revivals and video cassette releases of Stingray, Thunderbirds, Captain Scarlet and Joe 90.

Anderson was interviewed for the BBC's 1993 Doctor Who documentary, Thirty Years in the TARDIS. He joked that, despite his career of making children's programming, the "real tragedy of my life" was that his own son Jamie (appearing with him) was a Doctor Who fanatic.

By 1993 Archer published the trivia book Gerry Anderson's FAB Facts. Archer was killed in a car crash on London's orbital M25 motorway on his way to the publishers to collect one of the first print run to present to Anderson, and the book later had to be withdrawn from sale and thousands of copies destroyed as a result of a copyright dispute with ITC America.

The renewed interest enabled Anderson to return to television production, but several projects including GFI (an animated update of Thunderbirds) did not make it into production. Finally, in 1994, Anderson was able to get Space Precinct into production. It was followed by Lavender Castle, a children's sci-fi fantasy series combining stop-motion animation and computer-generated imagery.

In the meantime, the biography, which had been set aside since Archer's death, had been picked up again and was completed by Stan Nicholls from Archer's original notes and manuscript, finally being published in 1996 shortly before Lavender Castle went into production.

Around this time Anderson was reunited with his elder son, Gerry Jr., Anderson reportedly experienced powerful feelings of animosity toward his ex-wife Sylvia at the idea she had been responsible for his enforced estrangement from his son.

Later career
By December 1999, Anderson was working on plans for a sequel to Captain Scarlet, and he showed early test reels at a few fan conventions. These reels had the visual design and characters looking very much as they had in the original show, although the vehicle designs had been somewhat modernised. Several years after the initial tests the project evolved into the remake New Captain Scarlet, by which time the entire appearance had been significantly updated.

Anderson was appointed Member of the Order of the British Empire in the 2001 Birthday Honours for services to Animation.

Along with his business partner John Needham, Anderson created another new series entitled Firestorm, financed by Japanese investors and featured anime style animation. Other planned shows with other Japanese backers, including Eternity failed to come to fruition. Firestorm was sold throughout south-east Asia. Anderson and Needham parted company in 2003.

Anderson was originally approached to be involved in a live-action feature film adaptation of Thunderbirds as far back as 1996, but he was actually turned away by the producers of the 2004 film Thunderbirds, which was directed by Jonathan Frakes, after first being invited to meet with them. He distanced himself overtly from the project, later turning down an offer of $750,000 simply to write an endorsement of the film shortly before its release; Sylvia Anderson served as a consultant on the project and received a "special thanks" credit in the film. The film received poor critical reviews and was unsuccessful at the US box-office. Anderson disliked the film, describing it as "the biggest load of crap I have ever seen in my life".

New Captain Scarlet finally premiered in the UK in February 2005. The show cost £23 million to produce and was the most expensive children's programme ever to be made in the UK (until Ragdoll's In the Night Garden came out 2 years later). Many companies invested in producing toys and merchandise. Broadcaster ITV incorporated episodes into Ministry of Mayhem, an existing children's show, and showed it in two halves, separated by games and adverts. Disappointing merchandising sales followed. The accompanying comic lasted only six editions before being scrapped by its publishers. Anderson's displeasure at ITV's handling of the show was widely reported. The series was subsequently released on DVD.

2005 also saw the 40th anniversary of Thunderbirds, and a wide range of merchandise was produced to celebrate the event. In 2006, ITV re-ran the entire series on its fledgling CITV channel, a digital service available on cable, satellite and the Freeview service. ITV4, another digital channel, also ran repeats of UFO and Space: 1999 up until the end of 2009.

In March 2011, Anderson was working with Daniel Pickering and Annix Studios on a new project named Christmas Miracle, a children's CGI animated feature.

Death
In June 2012 it was reported that Anderson had been diagnosed with Alzheimer's disease. Anderson died in his sleep on 26 December 2012, at the age of 83. The news was announced on his son Jamie's website, who wrote, "I'm very sad to announce the death of my father, Thunderbirds creator, Gerry Anderson. He died peacefully in his sleep at midday today (26th December 2012), having suffered with mixed dementia for the past few years. He was 83."

Voice actor Matt Zimmerman, who voiced Alan Tracy and supporting characters in Thunderbirds. spoke to BBC News about Anderson's death praising his work saying "it's a big part of people's lives" saying also that "people speak of the shows with such affection, and I held Gerry with that kind of affection as well. I am very pleased to have known him and I feel very sorry for Jamie and his wife Mary." David Graham who voiced Gordon Tracy, Parker, Brains and Kyrano said it was "a very sad day".

Tributes from across the world of television and radio poured in, among them TV presenter Jonathan Ross, DJ Chris Evans, comedian Eddie Izzard and actors Brian Blessed and John Barrowman. Ross tweeted "For men of my age his work made childhood an incredible place to be." Blessed, who worked with Anderson on Space 1999 and The Day After Tomorrow said, "I think a light has gone out in the universe. He had a great sense of humour. He wasn't childish but child-like and he had a tremendous love of the universe and astronomy and scientists."

Fanderson chairman Nick Williams paid tribute to Anderson by saying "To those who met him Gerry was a quiet, unassuming but determined man. His desire to make the best films he could drove him and his talented teams to innovate, take risks, and do everything necessary to produce quite inspirational works. Gerry's legacy is that he inspired so many people and continues to bring so much joy to so many millions of people around the world."

The Humanist funeral was announced for Friday 11 January 2013 at Reading crematorium. His son Jamie went on to say that his father expressed his desire to let fans of the shows attend his funeral, alongside friends, family and cast members. Jamie also spoke about the number of messages sent by fans, saying, "We have been so touched by the outpouring of sympathy from all over the world. We have had messages from India, Uganda, Australia – and from people aged between seven to 70. It is so nice to know how my father touched people's lives across all the continents." Jamie went on to add, "But I'm proudest of him for the contribution he made to the Alzheimer's Society. He was so torn apart by his illness. But his involvement with the charity raised £1million in just a year."

Anderson was cremated, following a ceremony that brought together hundreds of colleagues, family and fans. Anderson's coffin was decorated with a floral Thunderbird 2 as his body was taken into the service, where musical scores of the Thunderbirds theme tune and "Aqua Marina" from Stingray were played. Amongst the hundreds in attendance was car owner Melvin Jarvis, who drove to the service in a full-scale replica of Lady Penelope's Rolls-Royce FAB1. Also in attendance was Shane Rimmer, who voiced Scott Tracy in Thunderbirds; he spoke about his time on the show, saying, "It was a truly unique experience. Gerry's office was like the Oval Office at The White House at times, such was the mystique of the place. Thunderbirds really broke a mould as it was one of the first TV shows that had appeal on both sides of the Atlantic."

The first episode of Strange Hill High, "King Mitchell", was dedicated to his memory.

Legacy
On 25 March 2013, in an announcement on the official Gerry Anderson website, Anderson's younger son Jamie announced that a number of projects that Anderson had been unable to finish during his lifetime were being developed by his company Anderson Entertainment and would be financed primarily through Kickstarter crowdfunding. On 27 July 2013 the name of the first Gerry Anderson legacy project was announced on the official Gerry Anderson website as a trilogy of novels entitled Gemini Force One. The first novel, Black Orchid, was published in 2014. In 2019 a pilot episode for a new puppet-based science fiction series based upon concepts developed by Anderson, Firestorm, was released on YouTube by Anderson Entertainment. It uses a combination of hand- and electronically controlled puppets and green screen effects in an updated form of Supermarionation dubbed "Ultramarionation". Production of a full-length series was scheduled to begin in 2019.

Music video

 * "Calling Elvis" for Dire Straits (1991)

Сommercials

 * Blue Skies Ahead (1960–61)

An info-commercial style advertising campaign for Blue Car European coach tours show during 1960–1961 in fifteen minute segments on British television.

Other

 * Thunderbirds 2086 (1982, Japanese anime series loosely based upon Thunderbirds; unaffiliated with Anderson)
 * Gemini Force One (2008, continued posthumously) – novel series

Other related works
Over the years, various British comics have published strips based on Anderson's creations. These started with TV Comic during the early 1960s, followed by TV Century 21 and its various sister publications: Lady Penelope, TV Tornado, Solo and Joe 90 (which were produced by a company affiliated with Anderson). In the 1970s there was Countdown (later renamed TV Action). There were also tie-in annuals that were produced each year featuring Anderson's TV productions.

title: Gerry Anderson


text:
Talk:December 23

Leap years
9 days remaining, 10 in leap years?

Does this make sense to someone who can explain it, or is it just wrong? GTBacchus 10:00 Jan 8, 2003 (UTC)

Lucci
Susan Lucci was born in 1947 and not 1946. Mike H 00:27, Aug 31, 2004 (UTC)

Tip's/Tibb's Eve
I'm from newfoundland and I was told as a child that the day before Christmas Eve was called Tip's Eve (or possibly Tibb's Eve, I was never able to fully acquire and decode the Newfie accent). Is this known of or was it just a thing in my small community? —The preceding unsigned comment was added by Offput (talk • contribs) 03:18, 24 December 2006 (UTC).

Festivus
Is there any reason to remove "fictional" from this "holiday" and using the silly tagline that is associated with it? It is as notable as "Steak & BJ Day".  -- Borameer TM  15:59, 14 February 2007 (UTC)
 * Holidays and observations is not for parodic or fictional events. I removed Festivus and it was restored.  Please explain here how Festivus meets the criteria for inclusion.  --Richardson mcphillips (talk) 15:37, 10 September 2018 (UTC)
 * Festivus meets the criteria for inclusion. Per WP:DOY, "Holidays and observances, if notable enough for inclusion, should be the subject of a Wikipedia article (or in the case of religious feasts, mentioned in a linked article). These entries should also be limited to those events that occur on the same date annually and to observances that are currently celebrated (not the date it was once celebrated or will be celebrated)."  Festivus is the subject of a very well-written and sourced Wikipedia article and is always observed on December 23.  Frank Anchor Talk 16:46, 10 September 2018 (UTC)

If it is a parody, as the Wiki article says, how is it "observed"? It's a joke. That's sort of what parody means. Richardson mcphillips (talk) 13:39, 12 September 2018 (UTC)

Byzantine-Arab wars
I'm adding this one in because theres too much modern day stuff. Tourskin (talk) 17:20, 22 April 2008 (UTC)

Slovenia election values
In [the article|https://en.wikipedia.org/wiki/1990_Slovenian_independence_referendum] about Slovenian independence election the result says 95.71% votes "yes", in the list says 88.5% Barrabas11 (talk) 18:25, 23 December 2022 (UTC)

 * You should probably ask this on the article's talk page, but as I understand it, 88.5% refers to the proportion of eligible voters, whereas 95.71% refers to the proportion of actual voters. Kiwipete (talk) 01:47, 24 December 2022 (UTC)

title: Talk:December 23


text:
River Don, Aberdeenshire

The River Don (Abhainn Dheathain) is a river in north-east Scotland. It rises in the Grampians and flows eastwards, through Aberdeenshire, to the North Sea at Aberdeen. The Don passes through Alford, Kemnay, Inverurie, Kintore, and Dyce. Its main tributary, the River Ury, joins at Inverurie.

Course of the river
The Don rises in the peat flat beneath Druim na Feithe, and in the shadow of Glen Avon, before flowing quietly past the ice-age moraine and down to Cock Bridge, below the picturesque site of the recently demolished Delnadamph Lodge. Several streams, the Dhiver, Feith Bhait, Meoir Veannaich, Cock Burn and the Allt nan Aighean merge to form the embryonic Don. Water from the north of Brown Cow Hill drains into the Don, while water from the west side runs into the River Spey and that from the south side into the Dee. The Don follows a circuitous route eastwards past Corgarff Castle, through Strathdon and the Howe of Alford before entering the North Sea just north of Old Aberdeen.

The chief tributaries are Conrie Water, Ernan Water, Water of Carvie, Water of Nochty, Deskry Water, Water of Buchat, Kindy Burn, Bucks Burn, Mossat Burn, Leochel Burn and the River Ury.

History
The river was recorded by the 2nd century AD cosmographer Ptolemy of Alexandria (d. c 168) as Δηουανα Devona, meaning 'goddess', an indication the river was once a sacred one. Near Kintore, not distant from the Don, is the Deers Den Roman Camp. In 1750 the Don's lower reaches were channelled towards the sea, moving its confluence with the sea northwards.

Hydrology
River levels and flows have been measured along the course of the Don at a number of gauging stations since 1969. The lowest of these is the gauge at Parkhill near Dyce, with a mean flow of 20.64 m3/s. The station measures 97% of the total 1312 km2 catchment of the river.

Prior to 2016 the maximum levels and flows were recorded during the floods of November 2002, with peak levels on the 22nd of that month reaching 5.07 m at Haughton near Inverurie, and 4.17 m at Parkhill. These were exceeded in January 2016 during the 2015–16 floods, when levels at Haughton reached 5.6 m, whilst those at Parkhill were over a metre higher than previously at 5.5 m. The resultant flooding forced residents along the river to evacuate their homes, in some cases with the help of local rescue teams. Areas affected included Port Elphinstone, Kintore, and Donside in Aberdeen where a number of residential care homes were evacuated as a precaution.

Economy
Strathdon attracts visitors for salmon and trout fishing as well as its castles and scenery. A 100kW hydro scheme at Tillydrone is on the former site of the Donside Papermill.

title: River Don, Aberdeenshire