My CPR

First Aid for Choking Children, still conscious

Again, don’t do this if the child is coughing forcefully or has a strong cry. Strong coughs and cries can help push the object out of the airway. Let them continue to cough it out. Encourage them to do so – they’ll be more able to respond to your telling them ‘keep coughing’ than baby would.

• If they can’t cough, or can’t cough any longer:
• Stand behind the person and wrap your arms around the person’s waist.
• Make a fist with one hand. Place the thumb side of your fist just above the person’s belly-button, well below the breastbone.
• Grasp the fist with your other hand.
• Pull in and up with your fists.
• Continue this until the object is dislodged or the person loses consciousness.

What will happen?

The aim is to get your fists under the person’s lungs. By squashing up on the lungs, you use the air they still contain to blow out the object. Like popping a cork from a bottle, hopefully the object will pop out. If it does, it can travel some distance too!

Practical Hints & Tips for Choking Children

• Try to stand with one foot between their feet before you ‘pull’ so you don’t just pull them off their feet.
• Keep your head out of the way. Don’t pull them backwards and have them hit your nose with their head!
• If you and the child are different sizes, one of you will have to kneel (probably you). Don’t try standing them on a chair to even things up, you’ll just pull them off the chair.
• If the child is in a wheelchair, put the brakes on. Try to reach round them and the chair if that works. If not, you may need to come round the front and do the treatment from there. (This time you’ll push in and up, not pull.)

What if the choking person is unconscious?

For all ages, current guidelines say ‘Start CPR’.

The idea is that (possibly) the chest compressions will dislodge the object – like the treatment for choking babies. At the same time the person who has become unconscious from choking will have been ‘not breathing’ for several minutes. They’ll be in need of full CPR very soon. Again, make sure the emergency services are on the way!

When you stop them choking

The object should come out – hopefully it will be obvious. If not, check between back blows and chest-thrusts for baby, check every few ‘pulls’ on a child. You should hear them crying (and you’ll be glad to!).

Of course, stop what you’re doing, but then don’t forget to reassess them. Make sure all the object(s) is fully clear and they can breathe freely.

Have them check over by the doctor, ambulance staff or hospital as appropriate. There is a risk for chest infection after choking, and a risk for organ damage after the various treatments. You do what is needed to save their life, but that can involve a lot of force to small people.

Other Choking Questions

Can you choke on liquids?

Not really. You can inhale liquids and they can make you cough, but the airway should clear quickly. (This applies to liquids people commonly drink, not all liquids!)

Can you choke on string/spaghetti?

Yes. Particularly if it coils up in the airway, and then absorbs moisture/saliva and swells.

What’s the ‘worst’ thing they can choke on?

In our opinion, broken balloon pieces. They can often come within reach of children. Get one of these stuck and the air you are relying on to ‘pop’ it out will simply make the balloon inflate a little.

What’s the treatment for Choking Adults?

Same as for children, but with more force!

Limitations

These guidelines reflect current practice. Guidelines will change at the end of 2011. Watch for an update around Christmas/New Year.