Choking:
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:
- First,
deliver five back blows between the person's shoulder blades with the heel
of your hand.
- Next,
perform five abdominal thrusts (also known as the Heimlich
maneuver).
- Alternate
between five back blows and five abdominal thrusts until the blockage is
dislodged.
If you're the only rescuer, perform back blows and abdominal thrusts before
calling 911 (or your local emergency number) for help. If another person is
available, have that person call for help while you perform first aid.
To perform abdominal thrusts (Heimlich maneuver) 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
five abdominal thrusts, if needed. If the blockage still isn't
dislodged, repeat the "five-and-five" cycle.
If you're alone and choking, you'll be unable to effectively deliver back
blows to yourself. However, you can still perform abdominal thrusts to dislodge
the item.
To perform abdominal thrusts (Heimlich maneuver) on yourself:
- 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 maneuver, 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 face
up 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.
- 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 maneuver and
CPR in a certified first-aid training course.
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