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Choking (Foreign Body Airway Obstruction)
Choking occurs when an object blocks
the passage that allows air in and out of the lungs. Children
are particularly at risk for choking because of the small
size of their air passages, inexperience with chewing, and
the natural tendency to put objects In their mouths. In children
aged 5-14 years, the majority of choking episodes are associated
with food, especially candy. For children aged 1-.4 years,
coins were involved in 18% of all choking-related emergencies.
Nuts and peanuts also commonly cause choking. Children under
3 years of age should never be fed nuts or other hard, crunchy
foods. Adults commonly choke on large pieces of food, often
while drinking alcohol. Elderly persons frequently choke on
semisolid foods. When the air passages are blocked, the patient
cannot breathe. Rapid first aid
for choking can save a life.
ADULTS & CHIIDREN > 1 YEAR
Air exchange=Good Signs and Symptoms
Mild blockage
Conscious/responsive
Can breathe in and out and can speak
Strong coughing or gagging as food/liquid “goes down
the wrong pipe”
May hear high-pitched squeaking or whistling noise (wheezing)
between strong coughs.
First Aid
Encourage the victim to cough
Stay with the victim
Watch closely
Be ready to take action if symptoms worsen
If blockage continues, alert EMS.
Note: An incomplete obstruction
of the airway may have less severe symptoms and be confused
with other causes of upper airway obstruction such as an asthma
/ reactive airway disease or croup. If the patient is coughing
forcefully, help them into a comfortable position. Alert EMS
or activate your emergency action plan.
Air Exchange=poor or none Signs
and Symptoms
Severe Blockage Clutching throat
victim cannot cough or make any sound
Responsive Blue lips, nails skin.
First Aid
Quickly ask “are you choking?”
If the victim nods yes or is unable to speak, cough, or cry-act
quickly!
Stand behind an adult or kneel behind a child.
Make a fist. Place the thumb side against the victim’s
abdomen, just above the navel.
Give quick inward and upward thrusts until the object is expelled
or the victim becomes unresponsive. (See skill guides #6 and
#7)
Late stages of pregnancy Or obese
First Aid
Perform chest thrusts, Stand behind
the victim.
Place your arms under the victim’s armpits, encircling
the chest. Place the thumb side of your fist on the middle
of the sternum.
Grasp your fist with your other hand and thrust backward.
Continue until the object is expelled or the victim becomes
unresponsive.
Self First Aid
Give yourself abdominal thrusts until
the object is expelled.
If that doesn’t work, press your abdomen quickly over
any firm surface (back of a chair, side of a table, etc).
Unresponsive
First Aid
Carefully get the victim to the ground, immediately alert
EMS or Emergency action plan.
Open the airway. Remove the object if you see it. Begin CPR.
Each time the airway is opened for rescue breaths, look for
an object In the victims throat. If you see it, remove it.
Continue CPR until the AED or EMS arrives or the victim shows
signs of life.
Caution:
Abdominal thrusts have been associated with severe and fatal
complications. Complications may occur even when abdominal
thrusts are performed correctly. DO
NOT perform the Heimlich maneuver on an adult or child
unless it is necessary. A victim who had an airway obstruction
that was removed by abdominal or chest thrusts should be evaluated
by EMS and seen by a physician to assure no internal injuries
resulted from this event.
INFANTS
Air Exchange=good Signs and symptoms
Mild blockage Responsive
Can breath in and out.
Crying, gagging.
Strong coughing
May hear high-pitched whistling or squeaking noise (wheezing)
between strong coughs.
First Aid
Stay with the victim
Watch closely
Be ready to take action if the symptoms worsen.
If blockage continues, alert EMS.
Air Exchange=poor
or none
Signs and symptoms
Severe blockage responsive
Victim cannot cough or make any sound
Blue lips, nails, skin
Passing out
First Aid
Keep the infant’s head lower
than the chest
Give 5 back slaps between the shoulder blades with enough
force to expel the object.
Turn the infant face up onto your lap or thigh.
Give 5 downward chest thrusts just below the nipple line with
enough force to expel the object.
Repeat until the object is expelled or the infant becomes
unresponsive.
Unresponsive
First aid
Place the infant on a firm flat surface.
Open the airway. Remove the object if you see it.
Begin CPR.
Each time the airway is opened for rescue breaths, look for
an object in the infants throat. If you see it, remove it.
Continue CPR for about 2 minutes (5 cycles). Alert EMS or
initiate your emergency action plan.
Caution:
The Heimlich maneuver is not recommended
for infants because you may damage internal organs. An infant
who had an airway obstruction that was removed by back slaps
or chest thrusts should be evaluated by EMS and seen by a
physician to assure no internal injuries resulted from the
event.
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