How to Treat Choking: Helping Someone in Distress

Choking is a life-threatening emergency that can occur when an object, often food or a small item, becomes lodged in a person’s airway, preventing them from breathing. Proper choking first aid techniques are crucial for preventing severe consequences such as brain damage or death. Without prompt and effective intervention, choking can result in unconsciousness, brain damage, or death within minutes. Health and safety education, emphasizes the importance of understanding and knowing how to treat choking in adults, children, and infants. This comprehensive guide outlines the necessary steps to recognize and respond to choking incidents, ensuring that you are equipped to intervene and potentially save a life.

Understanding Choking

Choking occurs when a foreign object becomes stuck in the airway, preventing oxygen from reaching the lungs and brain. This can happen to anyone, regardless of age, and can be caused by a variety of objects, including food, toys, and other small items. Choking can be prevented with proper safety measures, such as cutting food into small pieces and supervising mealtimes. However, if choking does occur, it is essential to know the proper first aid techniques to help the person.

Recognizing Choking First Aid

The first step in dealing with a choking emergency is recognizing the signs that someone is in distress. Choking can happen suddenly, and the ability to identify the symptoms early allows for quicker intervention.

• Common Signs of Choking:

  • Clutching the throat: This is the universal sign of choking and one of the most obvious indicators that a person's airway is blocked.

  • Difficulty breathing or noisy breathing: The person may make wheezing or high-pitched sounds as they attempt to breathe, but if the airway is completely blocked, no air will pass through.

  • Inability to speak or make any sound: If the airway is fully obstructed, the person won't be able to speak, cough, or make any sounds.

  • Weak or ineffective coughing: If the person is coughing weakly or unsuccessfully, it suggests that their airway is partially blocked.

  • Distressed facial expression: The person may appear panicked or frightened, and their face may show visible signs of distress.

  • Pale or blue skin (cyanosis): When oxygen levels drop due to the obstruction, the person's skin may turn pale or develop a bluish tint, especially around the lips and fingertips.

  • Loss of consciousness: If the obstruction is not cleared quickly, the person may lose consciousness due to a lack of oxygen.

• Confirming Airway Obstruction:

  • Ask the person if they are choking: If the person cannot speak or make sounds but nods or gestures that they are choking, it confirms that their airway is blocked.

  • Listen to their attempts to breathe: A person who is choking may have labored, noisy breathing, or they may not be able to make any noise at all if the blockage is severe.

  • Observe their behavior: Choking individuals often clutch their throat, gasp for air, or bend over as they struggle to breathe. These signs indicate a need for immediate action.

Identifying a Choking Person

Identifying a choking person can be challenging, but there are several signs and symptoms to look out for. These include:

• Inability to speak or make sounds

• Inability to cough or make a noise

• Clutching at the throat or chest

• Turning blue or purple

• Loss of consciousness

If you suspect someone is choking, it is crucial to act quickly and provide the appropriate first aid.

Treatment for Conscious Adults and Children: Abdominal Thrusts

When a person is choking but still conscious, immediate action is required to clear the airway before the situation worsens. The following steps outline what to do for adults and children who are choking but remain responsive.

• Encourage Coughing:

  • If the person is still able to cough forcefully, encourage them to continue. Coughing is the body’s natural way of trying to expel a foreign object from the airway.

  • Be mindful of weak or ineffective coughing. If the person’s coughing is not strong enough to clear the blockage, they may need further assistance.

• Perform Back Blows:

  • Position yourself: Stand slightly behind and to the side of the person for stability. Make sure they are leaning slightly forward to help ensure that the object exits the airway rather than moving further down.

  • Administer back blows: Using the heel of your hand, give five firm and forceful back blows between the person’s shoulder blades. Each back blow should be strong enough to create pressure that might dislodge the object but not so forceful that it causes harm.

  • Monitor the response: After each back blow, observe whether the object is expelled. If the object remains lodged, continue to the next step.

• Perform Abdominal Thrusts (Heimlich Maneuver):

  • Position your hands: Stand behind the person and wrap your arms around their waist. Make a clenched fist with one hand and place it just above the person’s navel, below the ribcage.

  • Perform the thrusts: Grasp your fist with your other hand and deliver quick, inward and upward thrusts, as if you are trying to lift the person. The goal is to generate enough pressure in the abdominal cavity to push air from the lungs and force the object out of the airway.

  • Repeat if necessary: Continue performing abdominal thrusts until the object is expelled, or the person loses consciousness. Be persistent, but take care to apply the appropriate amount of pressure to avoid injury, especially in smaller or older individuals.

• Alternate Techniques if Needed:

  • If the object is not expelled after several cycles of back blows and abdominal thrusts, continue alternating between the two techniques. Each method works differently to clear the airway, and a combination may be necessary to dislodge the object.

Treatment for Unconscious Adults and Children: Back Blows

If the person becomes unconscious as a result of choking, the situation becomes more severe. At this stage, it is vital to maintain circulation and restore breathing as quickly as possible.

• Lower the Person to the Ground:

  • If the person becomes unconscious, carefully lower them to the ground while supporting their head and neck to avoid further injury.

  • Place them on their back on a firm, flat surface to prepare for CPR.

• Activate Emergency Response:

  • Call 911 immediately, or instruct someone nearby to call for emergency medical assistance. If you are alone, make the call yourself before starting CPR.

  • Professional help is crucial in an unconscious choking situation, as advanced medical techniques may be required.

• Begin CPR:

  • Start with chest compressions: Perform 30 chest compressions at a rate of 100 to 120 compressions per minute. Push hard and fast in the center of the chest, making sure the chest fully recoils between compressions.

  • Check the airway: After performing compressions, open the person's mouth to check for any visible obstructions. If you can see the object, attempt to remove it with a finger sweep, but do not blindly sweep as this could push the object further down.

  • Give rescue breaths: If the object is not visible, attempt to give two rescue breaths. Tilt the person's head back slightly, lift their chin, pinch their nose, and blow into their mouth. Watch for the chest to rise. If it does not rise, reposition the head and try again.

  • Continue CPR cycles: Repeat the cycle of 30 chest compressions followed by two rescue breaths until emergency help arrives or the person regains consciousness and begins breathing again.

Treatment for Infants and Young Child (Aged 1 Year and Under)

Infants are especially vulnerable to choking due to their small airways and tendency to put objects in their mouths. The techniques for treating choking in infants are gentler but follow a similar principle of clearing the airway.

• Position the Infant:

  • Hold the infant face-down along your forearm, ensuring their head is lower than their body to allow gravity to assist in clearing the airway.

  • Support the infant's head and neck with one hand, keeping their airway open and secure.

• Perform Back Blows:

  • Using the heel of your hand, deliver five firm but gentle back blows between the infant's shoulder blades.

  • Be careful to avoid hitting too hard, but ensure each blow creates enough force to dislodge the object.

• Perform Chest Thrusts:

  • If back blows do not clear the airway, turn the infant face-up on your forearm, again ensuring their head is lower than their body.

  • Using two fingers, perform five chest thrusts on the center of the infant's chest, just below the nipple line. Press down about 1.5 inches with each thrust.

• Continue Alternating Techniques:

  • Alternate between five back blows and five chest thrusts until the object is expelled or the infant becomes unconscious.

  • If the infant loses consciousness, immediately begin infant CPR.

• If the Infant Becomes Unconscious:

  • Perform 30 chest compressions with two fingers in the center of the chest, followed by two rescue breaths. Continue CPR until help arrives or the infant regains consciousness and starts breathing.

When to Seek Emergency Help

If someone is choking, it is essential to seek emergency help as soon as possible. If you are the only rescuer, give back blows and abdominal thrusts first, then call 911 or your local emergency number for help. If another person is present, have them call for help while you give first aid. If you are alone and choking, call 911 or your local emergency number right away.

Prevention and Education

Preventing choking is crucial, especially for young children. Here are some tips to help prevent choking:

How to Prevent Choking

• Cut food into small pieces to prevent choking.

• Chew food slowly and thoroughly, especially if wearing dentures.

• Don’t laugh and talk while chewing and swallowing.

• Don’t drink lots of alcohol before and during meals.

• Keep marbles, beads, thumbtacks, latex balloons, coins, and other small toys and objects out of reach, particularly in children younger than 4 years old.

• Prevent children from walking, running, or playing when they have food and toys in their mouth.

• Don’t feed children younger than 4 foods that can easily get lodged in the throat, such as hot dogs, nuts, chunks of meat or cheese, grapes, hard or sticky candy, popcorn, chunks of peanut butter, or raw carrots.

• Supervise mealtimes with young children.

• Prevent older siblings from giving a dangerous food or toy to a young child.

Learning First Aid

Learning first aid is essential for knowing how to respond in a choking emergency. Here are some tips to help you learn first aid:

• Take a first aid and cardiopulmonary resuscitation (CPR) class.

• Or contact your local hospital or healthcare facility for a class schedule and more information.

• Practice the Heimlich maneuver and other first aid techniques to build your confidence and skills.

• Keep a first aid kit on hand and make sure it is easily accessible.

By understanding choking, identifying a choking person, seeking emergency help when necessary, and preventing choking through education and first aid training, you can help save lives and prevent choking emergencies.

Conclusion

Choking is a medical emergency that requires immediate and skilled intervention. MyCPR NOW emphasizes the importance of recognizing choking symptoms quickly and taking prompt action to clear the airway. Whether dealing with adults, children, or infants, knowing how to perform back blows, abdominal thrusts, or chest thrusts can make the difference between life and death. In cases where the person becomes unconscious, administering CPR while waiting for emergency medical help is crucial for maintaining circulation and oxygen supply. By being prepared and knowledgeable about these techniques, you can make a significant impact in choking emergencies, potentially saving lives when every second counts.