Medical Moment: Choking

Medical Moment: Choking

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Dr. Dan Hehir, Chief of Medical Staff, Board Certified in Emergency Medicine

Dr. Dan Hehir, Chief of Medical Staff, Board Certified in Emergency Medicine

 Dr. Dan Hehir answers this week’s question: What do I do if someone is chocking?

Every year in the US about 3000 people die from choking. Knowing how to immediately treat someone who is choking could save a life.

The steps are simple.

First, if someone is choking, assess the situation. If they are able to cough, speak or breathe, do not intervene. It is best to let the person cough the foreign body out.

If the person is conscious, but cannot cough, talk, or breathe – take action. If someone else is available, have them call 911 while you perform the Heimlich maneuver. To do this, approach the patient from behind and tell them what you are doing. Take one hand and make it into a fist. Place this just under the rib cage and above the navel. Then grasp your fist with your other hand. Then do abdominal thrusts pulling your fist backward and upward under the person’s rib cage. This increases pressure on the diaphragm and can help force the foreign body out of the airway. Continue to do this until the obstruction is relieved or the person becomes unconscious. Should they become unconscious, CPR is then needed. If you feel comfortable doing CPR do 30 chest compressions, check the airway to see if a foreign body can be retrieved, and then give two rescue breaths. Continue this until the foreign body is expelled or more highly trained help arrives.

Children over the age of one are treated the same as adults in this algorithm. For pregnant women in late pregnancy or very obese people, you may use the Heimlich maneuver using chest thrusts instead of abdominal thrusts.

For children less than one year of age, abdominal thrusts are not advised.

If an infant is conscious, but not able to breathe, cough or cry, lay the child across your forearm or lap with their head lower than their body and face down. Then do five back blows between their shoulders. Next, turn the infant over on your arm or lap and give five chest compressions. Place your fingers just below the nipple line, and push down one and a half inches. Alternate five back blows with five chest compressions until the foreign body is expelled.

If the infant becomes unconscious, lay the child onto a flat surface. Do 30 chest compressions, open the child’s mouth and look to see if a foreign body is within reach. If so, remove it, if not give two small rescue breaths. Repeat this cycle until the foreign body is expelled or until more highly trained help arrives.

Everyone should know how to help someone who is choking. It takes no special skills and is easy to learn and remember. Take two minutes to review the following videos on youtube and you’ll be ready if this ever happens to someone near you. You could save a life!

Adult and children over one choking video:

Children less than one choking video:

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