BLS for the Healthcare Provider: Choking Relief for Adults, Children, and Infants

What are the signs of SEVERE foreign-body airway obstruction?

- clutching of the throat (universal choking sign) - unable to speak/cry - poor or no air exchange - weak, ineffective cough/no cough at all - high-pitched noise when inhaling/no noise at all - increased respiratory difficulty - possible cyanosis

What are the signs of MILD airway obstruction?

- good air exchange still exists - person can cough forcefully - person may wheeze between coughs

Use _____ thrusts (a.k.a. The Heimlich Maneuver) to relieve choking in a responsive adult or child. Do not do so on an infant.

abdominal

If an infant victim becomes UNRESPONSIVE, what should you do?

begin CPR, starting with chest compressions

If severe foreign-body airway obstruction continues and the victim becomes unresponsive, what should you do?

begin CPR, starting with chest compressions

Never perform a ______ ______ ______, because it may push the foreign body back into the airway, causing further obstruction or injury.

blind finger sweep

If the victim is pregnant or obese, perform ______ thrusts instead of abdominal thrusts.

chest

When attempting to rescue a person facing mild foreign-body airway obstruction, you should encourage the victim to do what?

continue coughing

What is the key to a successful outcome for the choking person?

early recognition of the problem

Choking is known as _______-_______ _______ _______.

foreign-body airway obstruction

What should you not do when attempting to rescue a person facing mild foreign-body airway obstruction?

interfere with the person's own attempts to relieve the obstruction; but stay with the victim and monitor the condition

When a choking victim loses consciousness, the muscles in the ______ may relax, allowing for complete (severe) airway obstruction to become just a partial obstruction.

larynx

Foreign bodies may cause a range of signs, from _______ to _______ airway obstruction.

mild severe

What are the two ways you can tell if you have successfully dislodged an airway obstruction in an UNRESPONSIVE victim?

1) able to feel air movement and see the chest rise when you give breaths 2) able to see - and safely remove - a foreign body from the victim's mouth

What are the steps to relieve choking in an unresponsive infant?

1) shout for help; send that person to activate the ERS and retrieve the AED. place the infant on a firm, flat surface. 2) begin CPR (starting with compressions) with 1 extra step: each time you open the airway, look for the object in the back of the throat. If you see an object and can easily remove it, remove it. also, note that you do not check for a pulse/breathing before beginning CPR. 3) if you are alone, after about 2 minutes of performing CPR, run to activate the ERS and retrieve the AED.

What are the steps to relieve choking in a responsive infant?

1) sit with the infant in your lap 2) if it is easy to do, remove clothing from the infant's chest 3) hold the infant facedown with the head slightly lower than the chest, resting on your forearm. support the infant's head and jaw with your hand. take care to avoid compressing the soft tissues on the infant's throat. rest your forearm on your thigh to support the infant. 4) deliver up to 5 back slaps, forcefully between the infant's shoulder blades. use the heel of your hand. deliver each slap with sufficient force in an attempt to dislodge the foreign body. 5) after delivering up to 5 back slaps, place your free hand on the infant's back, supporting the back of the infant's head with the palm of your hand. the infant will be adequately cradled between your 2 forearms, with the palm of one hand supporting the face and jaw while the palm of the other hand supports the back of the infant's head. 6) turn the infant as a unit while carefully supporting the head and neck. hold the infant faceup, with your forearm resting on your thigh. keep the infant's head lower than the trunk. 7) provide up to 5 quick downward chest thrusts in the middle of the chest, over the lower half of the sternum (the same location as for chest compressions during CPR). deliver chest thrusts at a rate of about 1 per second, each with the intention of creating enough force to dislodge the foreign body. 8) repeat the same sequence of up to 5 back slaps and up to 5 chest thrusts until the object is removed or until the infant becomes unresponsive.

The steps for performing abdominal thrusts are...

1. stand or kneel behind the victim and wrap your arms around the victim's waist 2. make a fist with one hand 3. place the thumb side of your fist against the victim's abdomen, in the midline, slightly above the navel and well below the sternum 4. grasp your fist with your other hand and press your fist into the victim's abdomen with a quick, forceful, upward thrust repeat thrusts until the object is expelled from the victim's airway or the victim becomes unresponsive

If the victim becomes unresponsive and you begin CPR, send someone to activate the emergency response system and retrieve the AED. This is if you are not alone. If you ARE alone, provide about _____ minutes of CPR before leaving to activate the emergency response system and retrieve the AED yourself.

2

Let's say that the choking victim's condition worsens, and he or she becomes unresponsive. What are the steps for rescuing an unresponsive adult or child facing foreign-body airway obstruction?

The steps for rescuing an unresponsive adult or child facing foreign-body airway obstruction are: 1.) Call for help and send someone to activate the emergency response system and retrieve the AED. 2.) Gently lower the person to the ground. 3.) Begin CPR, starting with chest compressions. DO NOT take the time to check for a pulse. 4.) When you open the airway to give breaths, open the mouth wide. This way, you will be able to identify a foreign body. If you see a foreign body that you are able to remove with your fingers, do so. If not, continue CPR. 5.) Confirm that the ERS has been activated. If you are alone, leave the person after two minutes of CPR to activate the ERS and retrieve the AED yourself.

True or False: Chest compressions may create at least as much force as abdominal thrusts, so they may help expel the object.

True.

If mild foreign-body airway obstruction continues or if the situation worsens (where it becomes severe foreign-body airway obstruction), what should you do?

activate the emergency response system

When attempting to rescue an adult or child facing severe foreign-body airway obstruction, you should ask them what question first?

ask them if they are choking (if the victim nods "yes" and does not talk, severe foreign-body airway obstruction is present)

To relieve choking in INFANTS, use ______ ______ and ______ ______. Do not use ______ ______.

back slaps chest thrusts abdominal thrusts

If the victim becomes responsive or remains responsive after you have relieved them of the obstruction, encourage them to...

seek medical attention immediately; potential complications from abdominal thrusts (if performed) should be evaluated