Choking - A short reminder.

A person who is choking presents several problems. The obvious one is they are choking which means there is a restriction in them getting vital Oxygen. Secondly, they will probably be panicking and what's worse, the people around them are panicking too!

As a first aider you must be assertive and take control of the situation. As always, ask for permission to help. If it's a child or baby as permission from the parents or guardians. KEEP CALM and make sure you are safe. We use back thrust to "dislodge" the obstruction or abdominal thrust the put pressure on the diaphragm which in turn puts pressure on the lungs to push the obstruction out.

Adult and Child Choking: Encourage the person choking to continue to cough up whatever is blocking their airway and get them to look up. This will open their airway.

Put your arm around them, lean them slightly forward and give them 5 back thrusts between the shoulder blades using the palm and heel of your hand. If that's not worked them get their back into your hip, create a fist, thumb pointing inwards and place it above the belly button and below the rib cage. Place the free hand over your fist and pull in on the stomach for 5 thrusts. If this doesn't work, repeat the back thrusts followed by more abdominal thrusts. If after a series of 3 the obstacle is still there you need to call the emergency services. In my experience the emergency services are usually called quickly.

There is a caveat to the above abdominal thrusts, namely for pregnant women and markedly obese people. If the woman is pregnant, you wouldn't want to be pushing on the baby. For the markedly obese you physically can't get your arms around their waist. In both cases, prepare the same as you would normally, but do the thrusts in the same area as you would do CPR (in the lower middle of the chest bone) NEVER LET A CHOKING PERSON OUT OF YOUR SIGHT.

The choke may get worse and they could collapse when the air supply is cut off. In this case, help them to the ground, check to see if you can remove the obstruction from their months using a pincer pinch with your fingers - don't try and scoop it out. and start cardiac compressions. Continue with the cardiac compressions until the emergency services arrive or they cough up the obstruction. You may have dislodged the blockage.

Paediatric Choking: The same principles apply to a baby chocking as it does to an adult. Back thrust are the same - the back thrust are done between the shoulder blades but you can't do abdominal thrust

on a baby. What you do is the same as you would do for cardiac compression's, 2 fingers in the middle of the chest thrusting downwards 5 times. Always be prepared to commence CPR if they become unconscious.

Choking is a key skill in the courses I teach. It is frightening but as long as you keep a cool head and trust your training you will be doing all you can for the person choking.

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Thank you for taking time to read this most important of blogs and pass it on if you wish,

Kim Ronaldson - First aid instructor trainer

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