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First Aid for Choking
Choking can result in unconsciousness and cardiopulmonary arrest.
It is often caused by food or other foreign body lodged in the throat (airway).
Indeed, choking caused by foreign body airway obstruction accounts for about
3,000 deaths each year. The recognition and proper management of choking is
of key importance to safety in homes, restaurants, and other public places.
(Other conditions that may cause unconsciousness and/or airway
obstruction but are managed differently include stroke, epilepsy, swelling due
to infection, head injury, intoxication, overdose, coma of any cause, and heart
arrest.)
Prevention is No Accident
Adults:
- Cut food into small pieces.
- Chew food slowly and thoroughly, especially if wearing dentures.
- Avoid laughing and talking during chewing and swallowing.
- Avoid excessive intake of alcohol before and during meals.
Infants and Children:
Keep marbles, beads, thumbtacks, and other small objects out of their reach
and prevent them from walking, running, or playing with food or toys in their
mouths.
If you observe a "conscious;" ADULT choking:
- Ask, "Are you choking?"
- If the victim can speak, cough, or breathe, DO NOT INTERFERE.
- If the victim CANNOT speak, cough, or breathe, give subdiaphragmatic
abdominal thrusts (the Heimlich maneuver) until the foreign body
is expelled or the victim becomes unconscious. (Or in case of extreme
obesity or late pregnancy, give chest thrusts.)
- Be persistent.
- Continue uninterrupted until the obstruction is relieved or advanced
life support is available. In either case the victim should be examined
by a physician as soon as possible.
If the Victim Becomes Unconscious:
- Position victim on back, arms by side.
- Call out "Help!", or if others respond, call 911.
- Perform tongue-jaw lift and finger sweep to try to remove the foreign
body.
- Open airway (head-tilt/chin-lift), and attempt rescue breathing.
- If unsuccessful, give 6-10 subdiaphragmatic abdominal thrusts (the
Heimlich maneuver).
- Repeat sequence: perform finger sweep, open the airway, attempt rescue
breathing, perform abdominal thrusts -- until successful.
- After obstruction is removed, begin the ABC's of CPR if
necessary.
- BE PERSISTENT. Continue uninterrupted until obstruction is relieved or
advanced life support is available. When successful, have the victim examined
by a physician as soon as possible.
When there are signs of choking in an INFANT AND CHILD:
IF...
the infant or child is
breathing and continues
to be able to speak or
cough |
THEN...
do not interfere, but take
to an advanced
life support facility |
IF...
the infant or child
has a fever and a
history of illness
(the air passages
may be swollen) |
THEN...
transport immediately
to an emergency
care facility |
IF...
the infant or child
has ineffective
coughing, high
pitched inspirations,
and the inability to
speak or cry, |
THEN...
immediately begin the
obstructed airway
sequence described
below. |
Conscious Infant (under 1 year old)
4 Back Blows and 4 Chest Thrusts |
To dislodge an object in the airway of an infant:
- Supporting the head and neck with one hand, straddle infant face down,
head lower than trunk, over your forearm, supported on your thigh.
- Deliver four back blows, forcefully, with the heel of the hand between
the infant's shoulder blades.
- Immediately, while supporting the head, sandwich the infant between your
hands and turn onto its back, head lower than trunk, Using 2 fingers, deliver
four thrusts in the sternal region.
- Repeat both back blows and chest thrusts until foreign body is expelled
or the infant becomes unconscious.
Finger position for chest thrusts: Depress the sternum 1/2
to 1 inch for each thrust. Avoid the tip of the sternum.
Alternate method: Lay the infant face down on your lap, head lower than trunk,
and firmly supported. Perform 4 back blows, turn infant as a unit to the supine
position, and perform 4 chest thrusts.
Unconscious Infant:
- Call for help, or if others respond, call 911
- Perform tongue-jaw lift. If foreign body is visualized, remove it.
- Open the airway (head-tilt/chin-lift), and attempt rescue breathing.
- Perform 4 back blows, then 4 chest thrusts.
- If foreign body is not removed, persist with this sequence:
- attempt to visualize,
- attempt rescue breathing,
- give back blows,
- give chest thrusts until successful.
- If foreign body is removed and victim is not breathing, begin the ABC's
of CPR (cardiopulmonary resuscitation):
AIRWAY -open the airway;
BREATHING -if still no breaths, attempt
rescue breathing.
CIRCULATION -if no pulse, perform
chest compressions.
When successful, have victim examined by physician as soon as possible.
Conscious Child (over 1 year old)
To dislodge an object from the airway of a child:
Perform subdiaphragmatic abdominal thrusts (the Heimlich maneuver) as described
for adults.
Unconscious Child
If the child becomes unconscious:
Continue as for an adult, except
- DO NOT PERFORM BLIND FINGER SWEEP IN CHILDREN UP TO 8 YEARS OLD.
- Instead, perform a tongue-jaw lift and remove foreign body ONLY IF VISUALIZED.
Note: Abdominal thrusts are not recommended in infants. Blind finger sweeps
should not be performed on infants or small children.
Any victim on whom you begin first aid for choking or cardiopulmonary resuscitation
must be considered to be in need of advanced life support.
You can reach the Emergency Medical Services network on campus by dialing ext.
5555 or 9-911.
Off-campus you can dial 911. In other communities where 911 phone service is
not available be sure to make a list of emergency phone numbers for various
emergency services.
This information on First Aid for Choking is from a pamphlet
published by the American Heart Association. As you will understand from reading
the text, basic medical training is presumed(CPR, Basic First-Aid).
If you have never received any first training or wish
to update your training you can contact the American Red Cross.
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