Choking

The back of the throat is a very sensitive area that, if stimulated by a first aider trying to remove an object with the fingers, may cause the top of the windpipe to close completely through muscle spasm. Anything that lodges at the back of the throat, or within the windpipe, will cause the casualty to choke.
The treatment for choking has been recently revised and the methods used for small children and babies vary from those used for adults.

 

You will notice

Difficulty in speaking and crying.

Difficulty in breathing.

Acute anxiety.

 

You may notice

Inability to speak or to make any other sound.

The casualty grasps the front of the neck, or points to the mouth and throat.

The casualty becomes blue.

 

Choking in small children and babies.

Position the child or baby so that the head is lower than the trunk.

Sit and hold the child or baby face down, resting your forearm while supporting the head by firmly holding the jaw. Your arm should rest on your thigh for additional support.
 

Give 5 sharp slaps between the child’s or baby’s shoulder-blades. use the flat of your hand.

Check to see if any obstruction has come up in to the mouth.

If the backslaps fail, you will need to give up to 5 chest thrusts.

Turn the child or baby on to its back.
 

For a child : use the first and second finger of one hand, to find the position where the lower ribs meet the abdomen. Now slide your fingers up the line of the ribs to the notch where the ribs meet the breastbone. Place one finger in the notch and the other next to the first finger, on the breastbone .
Place the heel of the other hand on to the breastbone immediately next to the fingers this is the place at which you will press down.
 

For a baby : lay the baby along your thighs with its head nearest your knee.
 

Draw an imaginary line between the baby’s nipples. Place two fingers from your free hand on the breastbone approximately one finger’s breadth below this imaginary line (this is where you will do the chest thrusts).
 

Give 5 rapid downward chest thrusts.

If the obstruction has not moved, alternate between 5 backslaps and 5 chest thrusts.

Do not use the abdominal thrust on a baby or small child. You may cause severe damage to the abdominal organs, e.g. tear the liver.

If the child or baby becomes unconscious, call for an ambulance.

Give artificial ventilation to try to blow the obstruction farther down the baby’s or child’s airways so that air can enter one of the lungs.

If not breathing, alternate 5 breaths of artificial ventilation with 5 backslaps and 5 chest thrusts until help arrives or the blockage clears.
 

Choking in adults and older children

Position the casualty so that the head is lower than the trunk.

Give 5 sharp slaps between the casualty’s shoulder-blades, using the flat of your hand. Check to see if the obstruction has come up into the mouth.

If the backslaps fail, you will need to give up to 5 abdominal thrusts .
 

Do this by standing behind the casualty and encircling his/her waist with your arms. Grasp your hands together in the upper part of the casualty’s abdomen and pull upwards under the ribs sharply; do this 5 times. Check to see if the obstruction has come up into the mouth.
 

If the obstruction has not moved, alternate between 5 backslaps and 5 abdominal thrusts.

If the casualty becomes unconscious call for an ambulance.

If not breathing, alternate 5 breaths of artificial ventilation with 5 backslaps and 5 chest thrusts until help arrives or the blockage clears.
 

To carry out abdominal thrusts on the unconscious casualty, lay the casualty down on his/her back, kneel astride the upper thighs and join your hands together until your arms are locked straight on to the casualty’s upper abdomen. Push upwards under the ribs; repeat 5 times.

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