Removing an Airway Obstruction in Children
This is intended as a supplement to a full course by the American Heart Association. It is not to be used as your mainguide for patient care. Please contact the American Heart Association for class information.
CHILDREN (MORE THAN 1 YEAR)
Children who have a known or suspected infection that may be the cause of the airway's being closed should get immediate medical attention-continue mouth-to-mouth respiration on the way to the hospital.
If infection is not the cause of airway obstruction, in children over 1 year of age abdominal thrusts (Heimlich maneuver) are used without back blows.
- If the child is conscious and is standing or sitting, stand behind and wrap your arms around her waist.
- Make a fist and place the thumb side against the upper abdomen in the midline above the navel and well below the tip of the breastbone.
- Grasp your fist with the other hand and deliver 6 to 10 quick upward thrusts. Your hands should not touch the ribs or breastbone. Each thrust should be a separate and distinct movement.
If the child is lying down, either conscious or unconscious:
- Position the child face up or on her back and kneel at her feet. The astride position (figure 13.25) can be used with larger children.
- Place the heel of one hand on the child's abdomen in the midline slightly above the navel and well below the rib cage and lower tip of the sternum. Place the other hand on top of the fist and deliver several quick upward thrusts. A number of thrusts may be necessary to expel the object.
- Use the head tilt/chin lift maneuvers to help open the airway (see section on CPR, page 388). It is important not to interfere with the forceful and potentially effective efforts the victim is making to expel the object.
Note: If your initial efforts to dislodge the obstruction are not successful, keep trying. Repeat obstructed airway maneuvers, as deepening anoxia (loss of oxygen) may relax the victim and allow the obstruction to be more easily overcome.
- If you can see and grasp the obstructing object, remove it. Blind finger sweeps in the mouth (when you cannot see the obstruction), especially in infants and small children, should be avoided as the obstructing object may be pushed down farther.
Remember: Any object that can fit through a toilet-paper tube is a choking hazard for children under 3!!!
