A Loved One is Choking – What Would You Do?

Choking can occur unexpectedly, and young children and the elderly are particularly vulnerable. Being equipped with cardiopulmonary resuscitation (CPR) training and first aid skills is essential to effectively handle choking emergencies. This guide provides detailed instructions on recognizing choking, performing first aid, and the specific techniques required for different scenarios.

Recognizing Choking

Universal Signs

1. Clutching Throat:

   • The most recognized sign of choking is the victim clutching their throat with both hands.

2. Inability to Speak or Breathe:

   • A choking victim may be unable to speak or may have difficulty breathing.

3. Color Changes:

   • Look for changes in skin color, such as becoming pale or bluish, which indicate a lack of oxygen.

4. Gagging or Coughing:

   • Partial obstructions often cause forceful coughing or gagging.

5. Noisy Breathing:

   • Wheezing or high-pitched sounds when trying to breathe.

6. Panic or Distress:

   • The victim may show signs of panic or distress, such as wide eyes and frantic gestures.

7. Loss of Consciousness:

   • If the obstruction is not cleared, the victim may lose consciousness due to lack of oxygen.

First Aid Based on Consciousness

Conscious Victim

Ask for Permission:

• Always ask the conscious victim if you can help: “Do you need help?” or “Can I help you?” If they nod yes, proceed.

Heimlich Maneuver:

• If they consent, perform abdominal thrusts (Heimlich maneuver). Stand behind the person, wrap your arms around their waist, make a fist with one hand and place it just above their navel. Grasp the fist with your other hand and perform quick, upward thrusts until the object is expelled.

Unconscious Victim

Call 911:

• Immediately call emergency services before starting any intervention.

Check the Airway:

• Look for visible obstructions in the mouth. Do not attempt to remove anything you cannot see.

Perform Chest Compressions:

• Administer chest compressions to attempt to dislodge the obstruction. Check the mouth after each set of compressions. Avoid giving breaths until the airway is clear.

Performing the Heimlich Maneuver for Conscious Victims

For Adults and Children Over One Year

Position Yourself:

• Stand behind the victim with one foot between their feet for stability.

• Wrap your arms around their waist.

Hand Placement:

• Make a fist with one hand and place it just above the victim's navel.

• Grasp your fist with the other hand.

Thrusts:

• Perform quick, inward and upward thrusts. Use sufficient force to lift the diaphragm and expel air from the lungs, potentially dislodging the obstruction.

• Repeat until the object is expelled or the victim becomes unconscious.

Performing Back Blows

For Conscious Victims

Call 911:

• Always call 911 before beginning back blows.

Position the Victim:

• Have the victim lean forward at the waist, so their torso is parallel to the ground.

• Support them with one arm across their chest.

Administer Blows:

• Using the heel of your hand, deliver firm blows between the shoulder blades.

• Perform up to five back blows, checking if the obstruction is dislodged after each blow.

Performing CPR on an Unconscious Choking Victim

Call 911:

• Ensure emergency services are on the way.

Check for Obstruction:

• Tilt the head back and look into the mouth. If you see an object, remove it carefully without pushing it further down the throat.

Chest Compressions:

• Place the heel of your hand on the center of the chest (lower half of the sternum). Place the other hand on top and interlock your fingers.

• Perform chest compressions at a rate of 100-120 per minute, pressing down at least 2 inches for adults and children over one year.

• After every 30 compressions, check the mouth for the obstruction.

Cardiopulmonary Resuscitation (CPR):

• If the person becomes unconscious due to choking, immediately start cardiopulmonary resuscitation (CPR). This includes performing chest compressions and rescue breaths to prevent brain damage and save a life.

Continue Until Help Arrives:

• Continue cycles of 30 compressions and checking the mouth until emergency medical help arrives.

Special Considerations

Infants (Under One Year)

Back Blows and Chest Thrusts:

• Position the infant face down on your forearm, supporting their head and neck with your hand. Deliver five firm back blows with the heel of your hand between the infant's shoulder blades.

• Turn the infant face up, keeping the head lower than the chest, and use two fingers to give five chest thrusts in the center of the chest just below the nipple line.

Pregnant Women or Obese Victims

Higher Thrusts:

• For pregnant women or obese victims, perform abdominal thrusts (Heimlich maneuver) higher on the chest, around the base of the breastbone.

Elderly or Frail Individuals

Gentler Technique:

• Use a more controlled and gentle technique to avoid causing injury, such as broken ribs.

Detailed Steps for Abdominal Thrusts

1. Stand Behind the Victim:

   • Ensure you have a stable stance, with one foot slightly forward for balance.

2. Form a Fist:

   • Make a fist with one hand and place it just above the navel, thumb side in.

3. Grasp Your Fist:

   • With your other hand, grasp your fist to provide a firm grip.

4. Perform Thrusts:

   • Use a quick, upward and inward motion to perform the abdominal thrusts.

   • Apply enough force to create pressure in the diaphragm, which should help expel the object.

Detailed Steps for Back Blows

1. Position the Victim:

   • Have the choking person bend forward at the waist, maintaining a straight back.

2. Support the Chest:

   • Use one arm to support the person's chest and maintain their balance.

3. Deliver Back Blows:

   • With the heel of your hand, deliver firm back blows between the shoulder blades.

   • Check after each blow to see if the object is dislodged.

CPR for Unconscious Victims: Step-by-Step

1. Position the Victim:

   • Lay the victim on their back on a firm, flat surface.

2. Call 911:

   • Ensure emergency services are notified immediately.

3. Check Airway:

   • Open the victim's mouth and look for visible obstructions. Remove any visible object without pushing it deeper.

4. Chest Compressions:

   • Place the heel of one hand on the lower half of the sternum.

   • Place your other hand on top, interlocking your fingers.

   • Perform compressions at a rate of 100-120 per minute, pressing down at least 2 inches for adults.

5. Check the Mouth:

   • After each set of 30 compressions, check the mouth for the obstruction. Remove any visible object.

6. Continue Until Help Arrives:

   • Keep performing compressions and checking the mouth until emergency medical personnel take over.

Prevention and Training

Regular CPR Training:

• Enroll in regular CPR and first aid training to stay updated with the latest techniques and guidelines.

• Consider taking specialized courses for pediatric CPR if you care for children.

• Being prepared to prevent choking incidents by seeking training in lifesaving techniques, such as CPR and abdominal thrusts, is crucial.

Create a Safe Environment:

• Remove small objects that can cause choking hazards, especially for children and elderly individuals.

• Educate family members and caregivers on the signs of choking and the appropriate first aid response.

Advanced Techniques for Healthcare Providers

Magill Forceps:

• In advanced airway management, healthcare providers might use Magill forceps to remove obstructions from the airway.

Bag-Valve Mask Ventilation:

• Trained professionals can use a bag-valve mask (BVM) to provide ventilation to an unconscious choking victim.

Conclusion

Understanding how to recognize and respond to choking can save lives. Whether through the Heimlich maneuver, back blows, or chest compressions, knowing the appropriate technique for different situations is crucial. By taking CPR and first aid training, you can ensure you are prepared to act swiftly and confidently in an emergency. Sign up for a CPR course today and equip yourself with the skills needed to protect your loved ones and those around you. Regular practice, updated knowledge, and a proactive approach to learning can make all the difference in an emergency.