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"Foreign-body
airway obstruction should be considered in any victim, especially a younger
victim, who suddenly stops breathing, becomes cyanotic [turns blue], and loses
consciousness for no apparent reason.
Because early recognition of airway obstruction is the key to
successful outcomes, it is important to distinguish this emergency from
fainting, stroke, heart attack, epilepsy, drug overdose, or other condition
that cause sudden respiratory failure but are treated differently. Foreign-body airway obstruction
should be suspected in infants and children who demonstrate the sudden onset of
respiratory distress associated with coughing, gagging, stridor (a
high-pitched, noisy sound), or wheezing."
(Basic Life Support for Healthcare Providers, American Heart
Association, 1997). Below you will
find the step-by-step procedures for foreign-body airway obstruction management
on an adult. Below that you will
find information regarding children and infants. There is no theory, just the steps. Again, this is NOT a
substitute for formal hands-on training, but for information as a memory
refresher.
h
Heimlich Maneuver with Victim Standing or Sitting
§
Stand behind victim
§
Wrap arms around their waist
§
Make a fist with one hand
§
Place fist with thumb against abdomen, above the navel and
below the xyphoid
§
Grasp fist with other hand
§
Press into abdomen with quick upward thrusts
§
Repeat until object is expelled or victim becomes unconscious.
h
Heimlich Maneuver with Unconscious Victim (Abdominal Thrusts)
§
Place victim flat on back, face up (supine position)
§
Kneel astride victim's thighs placing heel of one hand above
the navel and below the xyphoid
§
Place second hand on top of first
§
Press into the abdomen with quick upward thrust
§
Observe the mouth to see if object is visible
§
If within reach, use the finger sweep to remove
·
Be careful not to force the object deeper
§
Repeat until object is expelled or medical personnel arrive
§
If object is expelled and victim is not breathing, perform CPR
When dealing with infants and children, there are several
things to keep in mind. If a
infant or child is still able to cough, cry, scream, etc, DO NOT STRIKE THE
CHILD ON THE BACK IN AN EFFORT TO DISLODGE THE OBJECT! If they can cry, then they are getting
adequate air. Striking them on the
back may result in a complete airway obstruction.
h
For a conscious infant
§
Hold infant face down resting on the forearm, support the head
by cradling the jaw in your hand
§
Deliver five back blows forcefully between the infant's shoulder
blades using the heel of one hand
§
Place your free hand on the back of the infant's head,
sandwiching the body between your arms
§
Supporting the infant's head and neck, flip the infant over so
they are now face up
§
Place fingers as if to give CPR chest compressions
§
Give five quick downward chest thrusts
§
Repeat until object is expelled or infant loses consciousness
h
For the unconscious infant
§
Give rescue breaths
§
If they do not cause the chest to rise, repeat back blows/chest
thrusts
§
Repeat sequence for 1 minute, then active EMS system
§
Resume efforts
§
If resume breathing, monitor until medical personnel arrive
h
For the conscious and unconscious child, perform steps as
for adults