What does “vital losses” mean in the following context: “Since the metabolic rate is fastest in the morning and slows throughout the day, it is more likely that the calories consumed during breakfast will be utilized by the body and not stored as fat. Skipping breakfast, on the other hand, may result in vital losses of muscle and a subsequent decrease in metabolism.“?

A5-year-old boy suddenly begins coughing while eating peanuts. he is choking and gagging. when he is brought to the ed, but he is awake and is able to give his name. on physical examination, his vital signs are stable. on examination of the chest, inspiratory stridor and intercostal and suprasternal retractions are apparent. which of the following is the most appropriate initial step in management? - allow patient to clear foreign object by spontaneous coughing- clear oropharynx with multiple blind sweeps with finger- position patient and perform back blows- stand behind patient and perform abdominal thrusts- perform emergency tracheostomy and take to surgery