Choke: To stop breathing by squeezing or obstructing the windpipe.
Choking is a very serious matter. When the windpipe becomes obstructed, one goes into a panic mode. Without oxygen reaching the lungs, an individual will become unconscious and can die without help. Permanent brain damage can occur in just four minutes.
We will be covering Conscious and Unconscious choking for Adults / Children / Infants.
First, we will begin with conscious choking. If a victim is conscious, they are still responsive. The most common sign for a conscious victim who is choking is for the victim to begin grabbing his/her throat. This is the universal sign for choking.
Adult / Child Choking
Conscious victim: Airway obstructed but not completely blocked. Victim is still alert and shows signs of life.
- The Adult / Child is making sounds e.g., coughing or crying. Encourage the victim to keep coughing. If the victim can make any sort of sound, the airway is not completely obstructed. By coughing, the victim is moving air up and down the windpipe, which can dislodge the object.
Conscious victim: Airway completely obstructed (Heimlich maneuver)
- Adult / Child victim: Ask the victim “Are you choking?” If the victim cannot speak, shakes head up and down in a yes mannerism, or doesn’t respond, act immediately by administering the Heimlich maneuver.
- For an adult victim you will stand behind them. On a child you stand behind them, but if they are much smaller than you kneel down to get down to their level.
- Make a fist with one hand and place thumb side of the fist directly above the naval (belly button).
- Wrap your other hand around the victim and place that hand over your fisted hand.
- Give inward and upward thrusts in one fluid motion until the object is removed or the victim becomes unconscious. You will want to use a little muscle and force when giving the Heimlich maneuver to have the most effective abdominal thrusts.
For an individual who is too large to place your hands around.
- Have victim stand with his/her back against a wall.
- Make a fist and put pinky side of that fist directly above the naval (belly button).
- Place your other hand on top of your fist.
- Give inward thrusts (push straight in) until the object is removed or the victim becomes unconscious.
Pregnant Victim (Chest thrusts)
- Stand behind the victim.
- Place your hands under the victim's armpits.
- Wrap your arms around the victim's chest.
- Place the thumb side of your fist in the center of the breastbone.
- Grab your fist with your other hand and administer chest thrust. Continue this until the object is expelled or until the victim becomes unconscious.
Choking alone. You can administer the Heimlich maneuver on yourself.
- You can physically give yourself abdominal thrusts like you would another individual (this requires more work than the other methods)
- You may also bend your stomach over an object, such as the top of a chair and thrust yourself against it, or drop your body weight on top of it.
Unresponsive Victim: Adult / Child
- Get the victim to the ground as safely as possible. Immediately call 9-1-1 (stay with a child for two minutes, performing CPR, and then call for help).
- Immediately begin CPR on the victim (30 chest compressions:2 rescue breaths)
- Every time the airway is opened (head tilt/chin lift) for rescue breaths look for an object in the victim’s throat. If you see an object remove it with a finger sweep.
- Continue CPR and checking for an object until an AED arrives, advanced help arrives, or the victim shows signs of life.
Definition: Infant Choking is when an infant (0-12 months) can’t breathe due to a blocked airway (throat or windpipe). This obstruction can be caused by food, a toy, or a variety of other objects.
Causes: Most infant choking is caused by an infant inhaling a small object that they have placed in their mouth. Infants will put anything in their mouths that will fit but common items choked on are coins, marbles, balloons, and toys.
- Infant is coughing, crying, making sounds – Since we cannot encourage an infant to keep coughing we need to just monitor the infant. Air is moving and can dislodge the object on its own. If the infant seems to be having continued trouble breathing administer rescue breaths and call 9-1-1.
- If infant cannot couch, cry, or make any sound
- Rest the infant face down on your forearm to support the spine and place your forearm on your lap or thigh for support. Keep the infant's head lower than the chest. Support the head and chin with your hand cupping the face to not suffocate the infant.
- Give 5 back blows between the shoulder blades with the heel of your hand with enough force to expel the object.
- If object is not expelled support the head and neck and turn the infant over (face up) onto your lap or thigh. Give 5 chest compressions just below the nipple line with 2 fingers with enough force to expel the object.
- Repeat back blows and chest compressions until the object is expelled or the infant becomes unconscious.
- Immediately shout for help and have a bystander call 911, if you are alone begin CPR on the infant for 2 minutes (5 cycles) then call for help.
- Place the infant on its back on a firm flat surface.
- Immediately begin CPR on the infant (30 chest compressions:2 rescue puffs)
- Every time you open the airway, look for an object. Remove the object with a finger sweep if you see it.
- Continue CPR until EMS arrives, another trained rescuer arrives, or the infant shows signs of life
Congratulations! You have completed the Choking training material. If you are comfortable with this material, please proceed to the AED training. If you are unclear on any topics, please review them before proceeding.