Lesson 5: Obstructed Airway

If the infant is crying or coughing forcefully, allow the infant to _____________but be prepared to clear the infant's airway if the infant's condition changes.

keep coughing

A patient who is choking typically has a

panicked, confused or surprised facial expression.

Signs of airway obstruction

recognize that a patient who cannot cough, speak, cry or breathe requires immediate care.

scapulae

shoulder blades

what to do when caring for a responsive infant after calling additional resources?

Then, perform a series of 5 back blows and 5 chest thrusts.

The patient's skin may initially appear flushed, but it will become pale or cyanotic as the body is

deprived of oxygen

After 30 compressions, open Mrs. Clark's mouth, look for an object and perform a _________ if an object is seen. If you do not see the object, do not perform a blind finger sweep.

finger sweep

An infant has an obstructed airway and back blows have been ineffective. You attempt chest thrusts. To about which depth would you perform the chest thrusts?

1 1/2 inches

Back blows steps

1. Position yourself to the side and slightly behind the patient. For a patient in a wheelchair or a young child, you may need to kneel. 2. Provide support by placing one arm diagonally across the patient's chest. 3. Then bend the patient forward at the waist so that the patient's upper body is parallel to the ground or as close as it can be. 4. Using the heel of your other hand, give firm back blows between the patient's scapulae (Figure 5-3). 5. Make each blow a separate and distinct attempt to dislodge the object.

what to do when a choking patient becomes unresponsive?

1. Carefully lower them to a firm, flat surface, while protecting their head. 2. Then, send someone to get an AED and additional resources (if appropriate and you have not already done so). 3. Immediately begin CPR, starting with chest compressions. Compressions may help clear the airway by moving the blockage into the upper airway and the oropharynx, where it can be seen and removed. 4. After each set of chest compressions, open the patient's mouth and look for the object before attempting ventilations. 5. If you see the object in the patient's mouth, remove it using a finger sweep (Figure 5-5). If you do not see the object, do not perform a blind finger sweep. 6. Next, attempt 2 ventilations. Never try more than 2 ventilations during one cycle of CPR, even if the chest does not rise. 7. Continue CPR, checking for an object before each set of ventilations.

Steps for Obstructed Airway Care for Adults and Children

1. Consent from adult or parent 2. abdominal thrusts

how to perform Back Blows?

1. Place your forearm along the infant's back, cradling the back of the infant's head with your hand. 2. Place your other forearm along the infant's front, supporting the infant's jaw with your thumb and fingers. 3. Hold the infant in a face-down position along your forearm using your thigh for support and keeping the infant's head lower than their body (Figure 5-6). 4. Use the heel of your hand to deliver a back blow between the infant's scapulae. Keep your fingers up to avoid hitting the infant's head or neck. 5. Provide 5 firm back blows, with each one separate from the others.

Abdominal trust steps

1. Stand behind the patient with one foot in front of the other for balance and stability. If possible, place your front foot between the patient's feet. If the patient is in a wheelchair or is a young child, you may need to kneel behind them. 2. Wrap your arms around the patient's waist. Use one or two fingers to find the navel. 3. Make a fist with one hand and place the thumb side of your fist against the middle of the abdomen, just above the navel. 4. Grab your fist with your other hand and give quick inward and upward thrusts (Figure 5-2, B). 5. Make sure each thrust is a distinct attempt to dislodge the object. 6. Continue delivering abdominal thrusts until the object is forced out and the patient can cough, speak or breathe, or until the patient becomes unresponsive.

steps for Chest Thrusts

1. Position the infant between your forearms, support the head and neck, and turn the infant face-up. Then lower the infant onto your thigh with their head lower than their chest. 2. Place two fingers in the center of the infant's chest, just below the nipple line. 3. Then give 5 quick chest thrusts about 11⁄2 inches deep. Let the chest return to its normal position, keeping your fingers in contact with the breastbone. Each chest thrust should be separate from the others. 4. Continue to provide sets of 5 back blows and 5 chest thrusts until the object is forced out and the infant can cough, cry or breathe, or, until the infant becomes unresponsive.

how to perform chest thrusts

1. Position yourself behind the patient as you would for abdominal thrusts. If the patient is a young child or is in a wheelchair, you may need to kneel. 2. Place the thumb side of your fist against the center of the patient's chest on the lower half of the sternum. 3. Then cover your fist with your other hand and pull straight back, providing a quick inward thrust into the patient's chest. 4. Make sure each thrust is a distinct attempt to dislodge the object.

To perform back blows, position yourself to the side and slightly behind Mrs. Clark. Provide support by placing one arm diagonally across her chest. Then, bend Mrs. Clark forward at the waist so that her upper body is parallel to the ground (or as close as it can be). Using the _____________________ Make each blow a separate and distinct attempt to dislodge the object.

heel of your other hand, firmly strike her between the scapulae.

After obtaining consent then, perform ______________ to clear the obstruction.

abdominal thrusts or alternate techniques

universal sign of choking is

act of clutching the throat

An adult patient becomes unresponsive while you are attempting to clear their obstructed airway. After providing 30 compressions, you open the patient's mouth and look for an object. If you do not see the object, which action should you attempt next?

2 ventilations

Continue performing cycles of ______________and 2 ventilations, checking for an object before each set of ventilations. Remember, never try more than ________during one cycle of CPR, even if the chest does not rise. Do not interrupt CPR for a breathing and pulse check until Mrs. Clark shows an obvious sign of life.

30 compressions 2 ventilations

If back blows alone do not dislodge the object, use a series of _____________________________ Always follow your facility's protocols.

5 back blows and 5 abdominal (or chest) thrusts.

If back blows alone do not dislodge the object, using a series of _______________ can be effective. Always follow your facility's protocols.

5 back blows and 5 chest (or abdominal) thrusts

If the patient cannot breathe or has a weak or ineffective cough, perform __________ or alternate techniques to clear an airway obstruction.

abdominal thrusts

If you deliver 2 ventilations and do not see the chest rise, what should i do?

Continue performing cycles of 30 compressions and 2 ventilations, checking for an object before each set of ventilations.

A child with an obstructed airway becomes unresponsive. Which action would be most appropriate to do first?

Gently lower the child to the ground and immediately begin CPR, starting with chest compressions.

An infant has an obstructed airway but is responsive. When administering back blows to the infant, you would use which technique to deliver the blows?

Heel of the hand between the scapulae

What should the team do after Lee completes 30 chest compressions?

Open Mrs. Clark's mouth, look for an object and perform a finger sweep if an object is seen.

While on break in the cafeteria, a person sitting at a nearby table begins choking. The person looks panicked and frightened. You go over to help and note that the person is not able to breathe, speak or cough. You summon additional resources and obtain consent. Which action would you do next?

Perform abdominal thrusts.

High-pitched squeaking noise during inspiration.

Stridor

What is the correct way to perform back blows?

Using the heel of your hand, firmly strike between the scapulae.

if you do not see any objects after checking the mouth then

You deliver 2 ventilations

If an infant becomes unresponsive while choking, provide care as you would for _______________________However, use your ____to remove an object, if you can see it

an unresponsive adult or child who is choking pinky

If the infant is unable to cry or is coughing weakly, ____________________ Obtain consent from the parent or guardian. If the parent or guardian is not available, consent is implied.

call for additional resources and to obtain an AED.

if airway obstruction does not get taking care earlier it can lead to

cardiac or respiratory arrest

If back blows do not dislodge the object in a responsive infant with an obstructed airway, try_________

chest thrusts

For a child, obtain consent from ______. If the parent or guardian is not available, consent is______

he parent or guardian implied

Most common noise during airway obstruction

hear stridor sound as the patient tries to breathe ,or nothing at all

consent implied

is consent which is not expressly granted by a person, but rather implicitly granted by a person's actions and the facts and circumstances of a particular situation

That's right. The correct area to perform chest thrusts is the _______-of the sternum.

lower half Center of the chest on the lower half of the sternum

Stand behind the patient, with one foot in front of the other and if possible, between the patient's feet. (B) Place the _____ of your fist against the ____ of the abdomen, just above the navel, and grab the fist with your other hand.

thumb side middle navel

what are other techniques for patient or they might be pregnant, in bed, abdominal thrusts just might not be effective, or in a wheelchair with features that make abdominal thrusts difficult to do?

use back blows, chest thrusts, or airway management techniques to dislodge the object from the airway.