Choking - How to recognise & treat.

Common Childhood ailments 3

Choking

One topic we can always rely on being a concern for parents on first aid courses is choking.  For obvious reasons the thought of their child choking is very scary for any parent or child carer.  People choke when an object slips into their airway preventing any, or enough, air entering their lungs.  The object is often food and some simple steps can be taken to avoid choking on food, particularly with younger children.  Always make sure young children are sitting down while they are eating and the old plea of ‘don’t talk with your mouth full’ is not just because it looks horrid!  Talking forces our airway to open, which means if there is food in our mouth it is quite easy for it to slip down ‘the wrong way’.  As choking is often a silent problem, making sure a child is well supervised while they are eating is also important.  We can never fully eradicate the risk of choking though, especially as children will put all variety of things in their mouths, so here are some simple steps to treat it –

1.       If the child is able to cough, encourage them to do so while trying to keep them calm.

2.       If they are unable to dislodge the object by coughing, don’t hang about.  Support the child across the front of their shoulders, lean them forwards and give up to 5 blows with the flat of your hand at the top of their back between their shoulder blades.  Check each time to see if the object has come out, in which case you can stop hitting them!

3.       If this is unsuccessful, stand (or kneel if they are much shorter than you!) behind them and place your arms round their body.  Make a fist with one hand, rotate it (so your thumb is towards their tum) and place it between their belly button and the bottom of their breast bone.  Grasp this fist with your other hand.  Using a sharp action, pull your fist inwards and upwards with enough force to lift the child off their feet.  Repeat this up to five times, stopping if the object is dislodged.  This is an abdominal thrust.

4.       Repeat the sequence of 5 back blows and 5 abdominal thrusts until the object comes out. Make sure an ambulance is called no later than 2-3 cycles if the blockage is not removed.

5.       If the child becomes unconscious you will need to ensure an ambulance has been called and start CPR immediately.

6.       Once the object has been successfully removed, take the child to hospital if you have performed any abdominal thrusts, they feel like the object is still there or they have a persistent cough or difficulty in swallowing.

These protocols change slightly for very young children and babies and all ages are covered fully on our paediatric first aid courses.  Nothing beats hands on practice with one of our choking vests as this must not be practised on someone who is not actually choking.