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
-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 an "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.)
-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 or CHILD:
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.
-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,
-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.
If the child becomes unconscious:
-Contimue 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 or off campus in Norman by dialing 911.
In other U.S. communities where 911 phone service is not available be sure to make a list of emergency phone numbers for various emergency services. Many other countries have national emergency numbers (similar to the U.S. 911 system). Check with local officials or the U.S. State Department to determine special emergency numbers you need to know when travelling.
The source for this First Aid for Choking page is from a pamphlet published by the American Heart Association. You can reach the OKC AHA office at (405)-942-2444. You can pick up a copy of this and other health/safety brochures at the OUPD headquarters.
As you will understand, from reading the text on this webpage, basic medical training is presumed (CPR, Basic First-Aid).
If you have never received any first-aid training or wish to update your training you can contact the "Heart of Oklahoma" Chapter of the American Red Cross ( located in Norman at OU's University Research Park, serving Cleveland, Garvin and McClain Counties in Central Oklahoma) at 321-0591.
Click HERE for this month's online training calendar (and future months, too!)
on January 15, 2002.
and refdesk.com's "Reference Site-of-the-Day" AWARD
on January 16, 2002
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Developer: Richard M. Hamilton, OUPD