The Toads Favorite Fire Pads - Removing Airway Obstruction Adults, Children, Infants

How To Remove an Airway Obstruction

(A REFRESHER for people with 1st-Aid and CPR training)

This is intended as a supplement to information learned in a complete CPR course instructed by the American Heart Association. It is not to be used as your only guide for CPR unless in emergency situations. Please use this only as a guideline for the proper steps in CPR. For more information please contact your local American Heart Association for class information.

CHOKING AND OBSTRUCTED AIRWAY

DEFINITION AND CAUSE
People who are choking may still be conscious and have circulation but are unable to breathe because something- usually food-is lodged in the throat. Choking on food often occurs after drinking alcohol, which dulls feeling in the throat. Frequently, a choking victim clutches the throat with thumb and forefinger, a universal signal of distress. Children choke more frequently than adults, usually on a toy or food fragment. Infections such as croup or epiglottitis can produce extreme swelling that blocks the airway. If a child with a fever, a barking cough, or known infection develops an obstructed airway, do not waste time trying to open the obstructed airway-you probably will not be able to clear it. Get the child to a hospital emergency room at once while continuing efforts at mouth-to-mouth breathing.

DIAGNOSIS AND TREATMENT OF A CONSCIOUS VICTIM
Before you do anything to assist a person you think is choking, ask the victim to talk. If talk is possible, the airway is not completely obstructed and it is best to leave the victim alone until he can dislodge the food or object himself by coughing, throat-clearing, or with his fingers. If the victim cannot talk, the airway is completely obstructed and you should assist in dislodging the obstruction. The technique recommended by the American Heart Association is a series of abdominal thrusts known as the Heimlich maneuver.

ABDOMINAL THRUSTS, OR HEIMLICH MANEUVER (5-6 SECONDS)
1. The victim should be sitting or standing. Grasp the victim from behind with your hands around his waist.
2. Make a fist with one hand and place the thumb side on the victim's abdomen, midway between the waist and the rib cage. Grasp the fist with your other hand and thrust forcefully inward and upward. Each new thrust should be a separate and distinct movement (see figure 13.18). This maneuver can be done successfully if the victim is sitting in a straight-backed chair (such as in a restaurant).

You can also perform the Heimlich maneuver on yourself.
1. Make a fist with one hand, place the thumb side midline in the upper abdomen above your navel and below your breastbone, grasp the fist with your other hand and then press inward and upward with a quick motion.
2. If this maneuver is unsuccessful, you should press the upper abdomen over the back of a chair, the side of a table, or porch railing. Several such thrusts may be needed to dislodge the object and clear the airway.

CHEST THRUSTS (5-6 SECONDS)
1. If the victim is pregnant or especially obese, it is safer and easier to do a chest thrust rather than an abdominal maneuver. The same two-fist technique is used, but the victim is grasped at the breastbone instead of the abdomen

DIAGNOSIS AND TREATMENT OF AN UNCONSCIOUS VICTIM
If you have begun the initial steps of CPR, including attempts to open the airway, and you cannot see the chest rise and fall when you administer rescue breathing, you should assume that the airway is obstructed and assist the victim as follows.
1. ABDOMINAL THRUSTS (5-6 SECONDS)
1. Kneeling next to or astride the victim, place the heel of one hand on the abdomen midway between the waist and the rib cage.
2. Place the other hand on top of the first (as you would for chest compressions, but on the abdomen rather than the chest) and thrust inward and upward. Give several quick thrusts

2. CHEST THRUSTS (5-6 SECONDS)
1. With an unconscious pregnant or especially obese victim, substitute chest thrusts for abdominal thrusts.

2. Use the same hand position over the breastbone that you would for chest compressions, but do quick downward thrusts
3. FINGER SWEEP (6-8 SECONDS)
Sweep the mouth of the victim if abdominal or chest thrusts do not dislodge the obstruction.
1. Open the victim's mouth wide by grasping the chin.
2. Still holding the chin, bend the forefinger of the other hand and with your hooked finger probe deep into the mouth along the insides of the cheeks. Then go back to the open airway position and attempt rescue breathing
3. If the airway is still not open, back blows, abdominal (or chest) thrusts, finger sweeps, and rescue breathing should be repeated rapidly as many times as is necessary to remove the obstruction. Occasionally, an open handed blow to the back may dislodge the obstruction and can be tried at this time. The longer the victim goes without oxygen, the more relaxed the muscles become, and this may release the foreign object, so that one of these maneuvers may ultimately be successful.

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