Choking

Choking Adult: Conscious video summary

- Perform a scene survey - identify yourself and offer help; Send for first aid kit - Perform primary survey - check if the obstruction is mild or severe - if mild, encourage coughing - if severe, perform back blows and abdominal thrusts - Help the person sit down - Complete primary survey - Send for medical help - Record your findings

What are abdominal thrusts and how do they work?

- abdominal thrusts are artificial coughs - pushes the diaphragm up very quickly, forcing the air from the lungs and blows the obstruction out - For the best effect, keep your forearms off the abdomen and make each thrust a strong and sudden movement

Common causes of choking: Tongue

- tongue falls to the back of the throat when lying back - saliva, blood or vomit pools in the throat

Common causes of choking: Foreign objects

- food, toys, buttons, etc. in infants - gulping down a drink with food in mouth (adults) - foods and pills (elderly people)

Common causes of choking: Swelling

- injury to the throat area causes swelling of the airway - illnesses such as allergies, asthma, epiglottitis, croup etc. also cause swelling

Choking Adult: Conscious becoming unconscious video summary

- position face up, if they go unconscious - activate EMS - put on gloves - start CPR; 30 compressions to 2 breaths; look in mouth for object - If casualty regains consciousness, complete primary survey (ABC's); check for shock - preserve body heat

What first aid should I give a choking adult casualty who is found unresponsive?

1 - Begin ESM 2 - Assess Responsiveness 3 - Send or go for medical help and get an AED if available 4 - If necessary, turn the casualty face up and open the airway. Push backward on the forehead and lift the jaw to open the airway 5 - Check for normal breathing for at least 5 but no more than 10 seconds: - Keep the head tilted. - With your ear close to the casualty's nose and mouth: Look ... for chest movement Listen ... for sounds of breathing Feel ... for breath on your cheek

What first aid should I give a choking adult casualty who is conscious but may become unconscious?

1 - Begin ESM 2 - Determine if the obstruction is mild or severe - If the casualty can cough forcefully, speak or breathe, don't touch him. Tell him to try to cough up the object. If a mild obstruction lasts for a few minutes, get medical help. - If you suspect a severe obstruction, ask the casualty, "Are you choking?" If the casualty cannot cough forcefully, speak or breathe, use a combination of 5 back blows and 5 abdominal thrusts to try to remove the blockage. - If choking is caused by swelling of the airway from an infection, injury or allergic reaction - get medical help quickly. Abdominal thrusts will not help.

What first aid should I give a choking adult casualty who is conscious but may become unconscious? Cont.

3 - Perform Back Blows and Abdominal Thrusts - Ask the casualty to lean over, brace your arm across his chest and hit the middle of his upper back in between the shoulder blades 5 times. Use enough force to clear the object. - If the 5 back blows do not relieve the obstruction, go behind the casualty, brace yourself by placing your dominant foot in-between his legs and place your hands on top of his hip bones. Slide your hands around at that level until they meet and make a fist on his stomach, placing one hand over your fist. - Give each abdominal thrust with the intention of removing the object. Use only your fist—make sure you don't press against the ribs with your forearms.

What first aid should I give a choking adult casualty who is conscious but may become unconscious? Cont. 2

4 - Continue back blows and abdominal thrusts until the object is removed or the casualty becomes unconscious. - If the airway is cleared, give ongoing casualty care for choking. - If the casualty becomes unconscious, lower the casualty to the ground

What first aid should I give a choking adult casualty who is conscious but may become unconscious? Cont. 3

5 - Lower the unconscious casualty to the ground - Protect the head and neck as you lower the casualty. - Send someone to call for medical help. - Get an Automated External Defibrillator (AED) if possible. 6 - Begin cardiopulmonary Resuscitation (CPR) starting with compressions - If an AED is available apply the device as soon as possible and follow the voice prompts from the machine. The CPR sequence remains the same except that the first aider checks the mouth before attempting to give a breath

What first aid should I give a choking adult casualty who is found unresponsive? Cont.

6 - Perform 30 chest compressions. If an AED is available apply the device as soon as possible and follow the voice prompts from the machine. The CPR sequence remains the same except that the first aider checks the mouth before attempting to give a breath 7 - Try to breathe into the casualty's mouth. If the chest doesn't rise on the second try, the airway is blocked - try to clear the airway by giving another 30 chest compressions

What first aid should I give a choking adult casualty who is conscious but may become unconscious? Cont. 4

7 - Open the mouth and check for the obstruction - If the obstruction is visible, remove it carefully with a gloved hand. - If the obstruction is not visible, continue with CPR, at this point giving the breaths. - Push back on the forehead and lift the jaw. - Use a pocket mask or face shield and seal your mouth around the casualty's mouth. - Pinch the nostrils. - Blow in - watch for the chest to rise. - If the chest doesn't rise, reposition the head, check the seals at the nose and mouth and try again. - If the chest doesn't rise on the second try, try to clear the airway (Step 8).

What first aid should I give a choking adult casualty who is conscious but may become unconscious? Cont. 5

8 - Continue chest compressions 9 - Repeat looking in the mouth, attempting to ventilate and giving chest compressions 10 - If you remove the blockage or if the chest rises when you ventilate, give two breaths - If there is no response continue with the normal CPR sequence. - If the casualty begins to respond, give ongoing casualty care

What first aid should I give a choking adult casualty who is found unresponsive? Cont. 2

8 - Open the mouth and look for the foreign object. If you see something, remove it. Attempt 2 ventilations. If air won't go in, give 30 chest compressions 9 - Repeat looking in the mouth, attempting to ventilate and giving chest compressions

What if the casualty is pregnant or is larger than the first aider? Cont.

If the casualty becomes unconscious, lower the person to the ground and perform 30 chest compressions. When a pregnant casualty is positioned face up, place something under the right hip. This positions the baby off an important blood vessel in the mother

What special considerations apply if the choking adult is in a wheelchair? Cont.

If the casualty becomes unconscious, take her out of the wheelchair: - Pull the casualty forward, supporting her with your arm and leg - Grip the casualty's clothing and lower them to the ground. Use the strength of your legs rather than your back. - Supporting the casualty, and protecting the head as much as possible, roll the casualty to the floor in a face-up position - With the casualty face-up, resume first aid for choking, by performing CPR

What on-going care should I give the choking casualty once the airway blockage is removed?

If the casualty is conscious: - Monitor breathing often. Breathing difficulties can develop following a choking incident - Stay with the casualty until normal breathing returns - Urge the casualty to see a medical doctor - abdominal thrusts can cause internal injuries

What on-going care should I give the choking casualty once the airway blockage is removed? Cont.

If the casualty is semi-conscious or unconscious: - Call for medical help if not called already - If the casualty is breathing, place her in the recovery position and give first aid for shock - Stay with the casualty until medical help takes over Monitor ABCs

Self-Administered Abdominal Thrusts

If you are alone, try to alert someone that you're choking If you have a phone, dial 911 or go where someone can help you If choking is severe, give yourself first aid (abdominal thrusts)

What special considerations apply if the choking adult is in a wheelchair? *If a doctor, physiotherapist or other health professional has shown you a different way of giving abdominal thrusts to a person in your care, use the best method.

If you can reach around from behind the wheelchair (and the person can lean forward) , use abdominal thrusts as you would for any conscious adult casualty. If you cannot reach around the wheelchair: - Position the wheelchair against a wall - Put the wheelchair brake on - Put the heel of one hand, with the other on top, in the middle of the abdomen - Give sudden, inward/upward thrusts until the object is removed or the casualty becomes unconscious

What if the casualty is pregnant or is larger than the first aider?

Instead of back blows followed by abdominal thrusts, use back blows followed by chest trusts: - Stand behind the casualty - Wrap your arms around the chest, keeping arms horizontal and snug up under the armpits - Place your fist against the lower half of the breastbone, thumb-side in - Hold the fist with your other hand and pull inward forcefully - Give each thrust with the intention of removing the blockage - Continue giving back blows followed by chest thrusts until the object is removed or the casualty becomes unconscious.

Complete airway blockage

There is no air exchange; the person cannot cough, speak or breathe. Without first aid the casualty may die

Severe Obstruction

airway is partially blocked and there is poor air exchange; the person cannot cough forcefully, has trouble breathing and speaking

Mild Obstruction

airway is partially blocked but there is still a good air exchange and the person can still cough forcefully, breath and speak - if the mild obstruction lasts for a few minutes, get medical help

Signs and symptoms associated with choking

important to recognize a mild or severe obstruction because the first aid is different - grabbing the throat - When air supply to the lungs is first cut off, the casualty's face becomes reddish, grey and the lips and earlobes become bluish. This is called cyanosis

What is choking?

when the airway is partially or completely blocked, reducing or cutting off airflow to the lungs Two choking situations: 1 - A conscious choking person who may become unconscious while you are giving first aid 2 - An unconscious person who has a blocked airway