How to Manage a Child or an Infant who is Choking

Guest post: Hello, my name is Carla and I own a business called First Aid Confidence. This is my fourth blog for Mumsnet Local. This month I will be discussing how to manage a child or an infant who is choking. I have spoken to many parents who have told me that they have been in a situation where their child or baby is choking and they have used the techniques that I will discuss and they have been successful in removing the obstruction and ultimately saving their childs life.

FirstAidConfidence_LogoChoking caused by a Partial Obstruction
A partial obstruction is where an object has become lodged within an airway, which can cause discomfort and pain and may cause the airway to become inflamed as the area continues to be irritated. A partial obstruction therefore may cause the airways to swell and narrow but air is still able to pass by the object and travel into the lungs.

A partial airway obstruction is likely to scare a child and they may start to panic. As air can pass by the object they will be able to speak to you and cough.

How to manage a Partial Obstruction
If a child has a partial airway obstruction, try to keep them calm and ask them to cough or to have a drink to try to dislodge the object. This may take some time depending on the object that has become lodged in the airway but air can still pass into the lungs, therefore this situation is not life threatening. If the object is not dislodged through these methods then you may need to visit your GP or your local A & E department to have the object removed.

A partial obstruction may be harder to recognise with an infant as they cannot tell you what is wrong but they will have the natural reflex to cough to try to dislodge the object. If the infant appears well you can try to give them a drink to dislodge the object again if the problem is persisting then visit your GP or your local A & E department.

 Choking caused by a Full Obstruction
A full obstruction is where an object has become lodged within the airway and it fills the whole width of the airway, which means that air cannot pass the object and travel into the lungs.

With a full obstruction a child will be extremely scared. They will not be able to speak or cough as air cannot pass by the object. This situation is an emergency and requires an immediate response to try to dislodge the object.

An infant will become silent and they may become pale and their lips may become slightly blue in colour as they are unable to breathe in any oxygen.

How to manage a Full Obstruction
If a child has a full airway obstruction then the management involves back blows and abdominal thrusts.
To administer back blows:

  • stand the child up
  • stand sideways on to them
  • support them with your arm
  • deliver back blows between the shoulder blades with your other arm

After each back blow check if the object has become dislodged. Repeat the back blows up to a maximum of 5 times.

Back blows are demonstrated in the photos below.BACKBLOW1-2If the back blows are not successful then you need to start delivering abdominal thrusts.

To deliver abdominal thrusts:

  • stand behind the child
  • bring your arms across their abdomen
  • make a fist with one hand and place your thumb flat against their abdomen just above their belly button
  • place the other hand over the fist
  • press against the abdomen in a very quick inward and upwards motion

 

Abdominal thrusts are shown in the photo below.AB THRUSTAgain you need to check after each abdominal thrust if the object has become dislodged and again this manoeuvre can only be repeated up to 5 times.

Any person that receives abdominal thrusts must seek further medical attention as there is a risk that internal damage may have been caused as a result.

If these techniques are not successful then you can start the back blows again but an ambulance must be called.

If the child becomes unconscious and is not breathing then you will need to commence CPR as explained in my previous blog.

If an infant has a full airway obstruction then the management involves back blows and chest thrusts but with the infant supported by your arm and your leg.

To deliver back blows to an infant:

  • sit down, place the infant face down along your arm with your arm on your leg
  • position your legs so that your knee is pointing slightly towards the floor
  • support the infants head with your hand but do not cover their mouth
  • deliver back blows between the shoulder blades

The correct position to deliver back blows to an infant can be seen in the photo below.

INFANT TAfter each back blow check if the object has become dislodged. Repeat the back blows up to a maximum of 5 times.

If the back blows are unsuccessful then you will need to start delivering chests thrusts.

To deliver chest thrusts:

  • turn the infant over on your arm so they are facing upwards and support them on your other leg
  • place your first two fingers in the centre of the infants chest and press quickly

The correct position to deliver chest thrusts to an infant can be seen in the photo below.

INFANT CHESTChest thrusts can be delivered up to 5 times also, checking after each one. If this is not successful then you will need to call for an ambulance and continue with the back blows.

CPR will need to be commenced if the infant becomes unresponsive.

It is important to note that with any choking situation it is not advised to put your fingers inside the persons mouth unless the object is very near the opening of the mouth and you can remove it easily.

Next month I will be discussing the Management of Bleeding and Shock for Children and Infants.

A little bit about me and First Aid Confidence.

The purpose of First Aid Confidence is to deliver affordable, effective First Aid Training in a professional yet relaxed manner that enables every learner to obtain the knowledge and skills that they require to perform First Aid competently and confidently. I want everybody who attends one of my courses to have the knowledge and confidence to carry out first aid should the need arise and I am committed to ensuring that every person has the opportunity to learn first aid. My previous role was within the ambulance service and I am a fully qualified first aid instructor. I offer first aid at work courses as well as paediatric first aid courses that meet Ofsted requirements and I am also keen to provide bespoke courses for parents who want to learn the skills needed to manage situations such as a child choking or an unconscious child.

Visit my website at www.firstaidconfidence.co.uk to find out more about the courses and other benefits that First Aid Confidence provides. You can also email me at carla@firstaidconfidence.co.uk or call me on 07939 885330 for an informal chat about First Aid Training.

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