The Universal Choking sign and First aid for choking

Dear Aunty Nurse Readers,

Have you ever choked on food or watched a child choke on a little piece of toy or anything of that sort? Do you remember what you did? Many times we give water and giving water is the average response but is it the right one?

First aid for choking babies

Once my room-mate went to bed with Tom Tom (mint) in her mouth. She woke up in the middle of the night and started to cough. I remembered that I had given her Tom Tom just before bed and somehow my brain responded so quickly. I had seen a movie where someone was choking in a restaurant and the person performed what I now know is called the Heimlich Manoeuvre so I did the same thing and the tablet flew out of her mouth. I was so relieved that I knew what to do and so we went back to bed and that was that.



The first thing you need to learn is the universal sign for choking. How to let people know you're choking? Here are some tips from the Mayo Clinic:

Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.

The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:

Inability to talk

Difficulty breathing or noisy breathing

Inability to cough forcefully

Skin, lips and nails turning blue or dusky

Loss of consciousness

If choking is occurring, the Red Cross recommends a "five-and-five" approach to delivering first aid:

    

Give 5 back blows. First, deliver five back blows between the person's shoulder blades with the heel of your hand.

 Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich Manoeuvre).

 Alternate between 5 blows and 5 thrusts until the blockage is dislodged.

The American Heart Association doesn't teach the back blow technique, only the abdominal thrust procedures. It's OK not to use back blows, if you haven't learned the technique. Both approaches are acceptable.

To perform abdominal thrusts (Heimlich Manoeuvre) on someone else:

Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.

Make a fist with one hand. Position it slightly above the person's navel.

Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust as if trying        to lift the person up.

Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.

If you're the only rescuer, perform back blows and abdominal thrusts before calling 123 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.

If the person becomes unconscious, perform standard CPR with chest compressions and rescue breaths.

To perform abdominal thrusts (Heimlich Manoeuvre) on yourself:

First, if you're alone and choking and you have a landline phone,  your local emergency number (123 for LASEMS, Lagos only) immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.

Place a fist slightly above your navel.

Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.

Shove your fist inward and upward.

Clearing the airway of a pregnant woman or obese person:

Position your hands a little bit higher than with a normal Heimlich Manoeuvre, at the base of the breastbone, just above the joining of the lowest ribs.

Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.

Repeat until the food or other blockage is dislodged or the person becomes unconscious.

Clearing the airway of an unconscious person:

Lower the person on his or her back onto the floor.

Clear the airway. If there's a visible blockage at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.

Begin cardiopulmonary resuscitation (CPR) if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.

Clearing the airway of a choking infant younger than age 1:

Assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh.

Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object.

Hold the infant faceup on your forearm with the head lower than the trunk if the above doesn't work. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions.

Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency medical help. 123 for Lagos, Nigeria.

Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.

If the child is older than age 1, give abdominal thrusts only.

To prepare yourself for these situations, learn the Heimlich Manoeuvre and CPR in a certified first-aid training course.

First aid for chocking for all age groups

I hope that these tips have been helpful. In the next post, I'll talk about Cardiopulmonary resuscitation (CPR) this would be needed if you're unable to help and the person in question losses consciousness.

Please rehearse these steps so you would not have regrets when you need them. 

Have a lovely day!

Signed,

Aunty Nurse