Dr Leigh Martens

General Practitioner

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First Aid Explained


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How to Treat an Unconscious Choking Adult or Child

 

 

We have selected the following expert medical opinion based on its clarity, reliability and accuracy. Credits: Sourced from the website wikiHow. Please refer to your own medical practitioner for a final perspective, assessment or evaluation.

 

Overview

If food or an object becomes stuck in the throat and blocks the flow of air, the flow of oxygen is cut off to the brain, and the person will eventually lose consciousness. It's always helpful to be prepared to treat an unconscious person who isn't breathing with cardiopulmonary resuscitation (CPR). One of the most important distinctions is knowing the differences between performing CPR on an infant (under the age of one), a child (age one to age eight), or an adult.

 

1: Treating an Infant

1. Check for breathing

If the choking infant (younger than one year old) has become unresponsive, you should first assess the situation. Quickly look around for food, toys, or whatever else may have caused the choking. Then check to see if the choking infant is showing any signs of breathing- chest rising or hearing breathing when you place your ear close to the infant's nose and mouth.

 

 

2. Have someone call emergency services (see "EMERGENCY NUMBERS" above)

If someone other than you is around, have that person call for an AMBULANCE while you begin taking first aid steps for the infant (see "EMERGENCY NUMBERS" above). Note that if you're the only person around and the baby isn't breathing at all, you should begin CPR before calling emergency services to first ensure that the baby receives circulation and oxygen.

  • If you're the only person around, but others are within earshot, then proceed through the next steps while periodically yelling for help. Ideally, someone else will be able to call emergency services as you attend to the baby.

 

 

3. Look for an obvious obstruction

With the infant laying flat, tilt the baby's head back and open his mouth. If you can see the object, remove it, but only if the object is easily removed. If the object is lodged, you don't want to risk pushing it farther into the infant's throat.

 

 

4. Attempt to clear the airway if the baby is conscious

If the baby is unconscious or shows no signs of breathing, skip to the next step. This step should only be taken if the infant is conscious; if the infant is unconscious, begin CPR immediately. If the unresponsive infant shows signs of reduced breathing, then you want to attempt to clear the infant's airway.


Try the following methods:

  • Sit, rest your forearm on your thigh, and place the infant facedown along the length of your forearm. The baby's head should be angled slightly downward as well. Use the heel of your hand to thump the middle of the infant's back five times with firm but not violent thumps. Watch to see if the object dislodges.
  • Roll the infant face up onto your forearm - again with the head lower than the torso. Place two fingers along the center of the baby's breastbone and quickly compress the chest five times. Check the mouth again to see if the action dislodged the object.
  • Repeat steps attempting to dislodge the object as long as the infant shows signs of breathing and a pulse. If the object dislodges and the baby resumes breathing, then call emergency services (see "EMERGENCY NUMBERS" above) and watch the infant closely until help arrives. If the infant stops breathing entirely at any time in the process or becomes unconscious, move to the next step.

 

 

5. Perform chest compressions

If the infant is unconscious, then you need to begin CPR. The method for giving an infant CPR is different than with a child or adult. Begin with chest compressions that will help maintain blood circulation to the brain.


To perform chest compressions on an infant:

  • Place the infant on a hard, flat surface - a table or even the floor will suffice.
  • Put two fingers on the center of the infant's chest. Imagine a straight line between the baby's nipples, and place the fingers just below where this line would be.
  • Press down with your fingers to compress the chest around 1.5 inches (3.8cm). The rate of the compressions should be around 100 per minute. However, ensure that the infant's chest rises all the way back up between compressions.
  • Perform thirty compressions, counting them aloud as you go.

 

 

6. Check the infant's airway

The compressions may have dislodged the object in the baby's throat. After thirty compressions, check the infant's airway again. Tip the baby's head back by lifting the chin while pressing down on the forehead with the other hand. Open the mouth to see if you can now remove the object - again, only if easily removable. Spend several seconds (no more than ten) feeling for breath and watching the infant's chest to see if he or she is breathing without assistance.

 

 

7. Perform rescue breathing if you are trained and comfortable doing so

If the unconscious infant still isn't breathing, you may want to perform rescue breathing techniques. However, new recommendations by the American Heart Association state that if you are untrained in CPR, you can just do chest compressions, and do not need to perform rescue breathing. To rescue breathe for the infant:

  • Cover the infant's mouth and nose with your mouth.
  • Use your cheeks (not your lungs) to deliver a quick, gentle blow of air that lasts one second. Provide a second breathe the same way.
  • Watch the baby's chest to see if it rises, which will tell you if the breaths are getting around the blockage or not.
  • If air does not go in, reposition the head and try one more breath. If the first breath goes in, give a second rescue breath, and then do another set of chest compressions.

 

 

8. Call emergency services if you're by yourself (see "EMERGENCY NUMBERS" above)

You want to repeat the cycle of CPR (thirty chest compressions followed by two rescue breaths) for two minutes - about five cycles. If no one else has called emergency services yet, this is the point where you should stop performing CPR to call emergency responders.

  • The seconds can be precious. Continue giving the baby assistance as the phone rings, etc.
  • Follow the emergency operator's instructions once the call is answered.

 

 

9. Repeat CPR cycles

Continue performing CPR cycles. Between chest compressions and rescue breathing, continue taking a few seconds to see if the blockage has been dislodged and if the baby has resumed breathing. Perform another cycle each time the baby shows no signs of life. Repeat until emergency responders arrive if necessary.

  • If you are getting tired, see if there is another person trained in CPR to take over for you or help with two person CPR.

 

 

 

2: Treating a Child

1. Check for breathing

If the choking child (between ages one and eight) has become unresponsive, you should first assess the situation. Quickly look around for food, toys, or whatever else may have caused the choking. See if the unresponsive child shows any signs of breathing - chest rising or hearing breathing when you place your ear close to the child's nose and mouth.

 

 

2. Have someone call emergency services (see "EMERGENCY NUMBERS" above)

If someone other than you is around, have that person call emergency services for an AMBULANCE while you begin taking first aid steps for the child (see "EMERGENCY NUMBERS" above). Note that if you're the only person around and the child isn't breathing at all, you should begin CPR before calling emergency services, ensuring that the child receives circulation and oxygen.

  • If you're the only person around, but others are within earshot, then proceed through the next steps while periodically yelling for help. Ideally, someone else will be able to call emergency services as you attend to the child.

 

 

3. Look for an obvious obstruction

With the child flat, tilt his head back and open his mouth. If you can see the object, remove it, but only if the object is easily removed. If the object is lodged, you don't want to risk pushing it farther into the child's throat.

 

 

4. Attempt to clear the airway if the child is conscious

If the child is unconscious or shows no signs of breathing, skip to the next step. This step should only be taken if the child is conscious; if the child is unconscious, begin CPR immediately.' If the choking child shows signs of reduced breathing, then you want to attempt to clear the airway by performing an abdominal thrust - also known as the Heimlich maneuver.


To perform the maneuver:

  • Wrap both of your arms around the child's waist while tipping him or her slightly forward.
  • Form a fist with one of your hands and position it on the child's stomach just barely above the navel. Grab your fist with your other hand.
  • Thrust the fist upward into the child's abdomen quickly. Perform five times if necessary while watching to see if the object dislodges.
  • Check for breathing. If the child stops breathing completely at any point or becomes unconscious, then proceed to CPR.

 

 

5. Perform chest compressions

If the the child is unconscious then you need to begin emergency CPR to maintain circulation and provide oxygen. Performing chest compressions on a child is different than performing on an infant or an adult.


To perform chest compressions on a child:

  • Set the child down on his back on a flat, hard surface (most likely the floor), and kneel down beside the child's shoulders, so you don't have to reposition between chest compressions and rescue breathing.
  • Place the heel of your hand on the child's chest between his nipples. Use only one hand since two can provide too much force.
  • Position your upper body over your hand and use your body weight and your arm to compress the child's chest. You want to compress two inches (five centimeters). Press quickly at a rate of around 100 compressions per minute. However, you want the child's chest to rise again completely between compressions.
  • Count the compressions aloud to a total of thirty.

 

 

6. Check the child's airway

The compressions may have dislodged the object in the child's throat. After thirty compressions, check the airway again. Tip the child's head back by lifting the chin while pressing down on the forehead with the other hand. Open the mouth to see if you can now remove the object - again, only if easily removable. Spend several seconds (no more than ten) feeling for breath and watching the child's chest to see if he or she breathes without assistance.

 

 

7. Perform rescue breathing if you are trained to do so

If the child is small enough, place your mouth over his mouth and nose. Otherwise, you can use mouth-to-mouth or mouth-to-nose breathing. Pinch the child's nostrils closed for mouth-to-mouth breathing.


To perform a rescue breath on a child:

  • Cover the area with your mouth completely to form a seal.
  • Deliver a breath that lasts approximately one second into the child's airway. If air does not go in, re-position the head before you try one more breath.
  • Provide a second breath before returning to chest compressions.

 

 

8. Call emergency services if you're by yourself (see "EMERGENCY NUMBERS" above)

Repeat the CPR procedure (thirty chest compressions and two breaths) for five cycles - or two minutes - before you call emeregncy services if you have no one else around to call emergency responders for you (see "EMERGENCY NUMBERS" above).

  • Follow the emergency operator's instructions quickly, so you can return to CPR while awaiting help.

 

 

9. Continue performing CPR

Unless the child begins showing signs of life and breathing on his own, then you should repeat CPR cycles (thirty compressions and two breaths) until paramedics arrive and take over.

  • If you become tired, see if there is another person trained in CPR to take over for you or help with two person CPR.

 

 

 

3: Treating an Adult

1. Check for breathing

If the person has become unresponsive, you should first assess the situation. See if the person shows any signs of breathing at all - chest rising or hearing breathing when you place your ear close to the person's nose and mouth.

 

 

2. Call emergency services (see "EMERGENCY NUMBERS" above)

If another person is nearby, have that person call emergency services for an AMBULANCE while you begin taking first aid steps (see "EMERGENCY NUMBERS" above). If no one else is around to assist you, then make the call to emergency services yourself before beginning CPR.

  • Follow the emergency operator's instructions quickly, so you can return to CPR while awaiting help.

 

 

3. Look for an obvious obstruction

Lay the person out on her back on a hard, flat surface. Tilt her head back and open the mouth. If you can see the object, remove it, but only if the object is easily removed. If the object is lodged, you don't want to risk pushing it farther into the person's throat.

 

 

4. Attempt to clear the airway if the person is conscious

If the person is unconscious or shows no signs of breathing, skip to the next step. This step should only be taken if the person is still conscious; otherwise you should begin CPR immediately. If the choking person shows signs of reduced breathing, then you want to attempt to clear the airway.


Two methods are available based on how well you can move the person around:

  • Back blows are the easiest option for a person who you cannot easily move. Roll the person onto his side or back and use the heel of your hand to thrust against the person?s back between the shoulder blades. Repeat fives times, watching for the object to dislodge.
  • If you can lift the person, try abdominal thrusts (the Heimlich maneuver) by placing your fist just above the person's navel and quickly thrusting in and upward with both hands. Also repeat five times while watching for the object to dislodge.
  • Check for breathing. If the person stops breathing completely at any point or becomes unconscious, then proceed to CPR.

 

 

5. Perform chest compressions

If the person is unconscious, then you need to begin emergency CPR to maintain circulation and provide oxygen. Performing chest compressions on an adult is different than performing on an infant or a child.


To perform chest compressions on an adult:

  • Roll the person onto his back on a flat, hard surface (most likely the floor) and kneel down beside the person's shoulders, so you don't have to reposition between chest compressions and rescue breathing.
  • Place the heel of your hand on the person's chest between his nipples. Place your other hand directly over your bottom hand to provide more leverage.
  • Position your upper body over your hands and use your body weight and your arms to compress the person's chest. You want to compress two inches (five centimeters). Press quickly - a rate that allows you to perform 100 compressions per minute. However, ensure that the person's chest rises completely between compressions.
  • Count the compressions aloud to a total of thirty.

 

 

6. Check the person's airway

The compressions may have dislodged the object. After thirty compressions, check the airway again. Tip the person's head back by lifting the chin while pressing down on the forehead with your other hand. Open her mouth to see if you can now remove the object - again, only if easily removable. Spend several seconds (no more than ten) feeling for breath and watching the person's chest to see if she is breathing without assistance.

 

 

7. Perform rescue breathing if you are trained to do so

After thirty chest compressions, you want to provide two rescue breaths (remember the 30:2 ratio). You can use mouth-to-mouth or mouth-to-nose breathing, but ensure that you pinch the person's nostrils shut for mouth-to-mouth breathing.


To perform rescue breathing on an adult:

  • Cover the area (mouth or nose) with your mouth completely to form a seal.
  • Deliver a breath that lasts approximately one second into the person's airway. If air does not go in, re-position the head before you try one more breath.
  • Provide a second breath before returning to chest compressions.

 

 

8. Continue performing CPR

Unless the person begins showing signs of life and breathing on his own, then you should repeat CPR cycles (thirty compressions and two breaths) until paramedics arrive and take over.

  • If you become tired, see if there is another person trained in CPR who can take over or assist with two person CPR.

 

 

 

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