Jan 18, 2010

Baby choking! What do I do?

In my previous post, I mentioned that the "Heimlich maneuver" is no longer used by the Red Cross and many other medical organizations. I also promised that I would explain why.

But first things first. There are a few important thing that were not mentioned by the instructional video on the choking treatment, a.k.a. "Heimlich maneuver," for kids.

Here they are:

1. Don't use aggressive intervention if the baby can still cough. Coughing is the body's way of clearing one's airway. It is the safest way to remove an airway blockage.

So if the baby can still cough or cry, do not use abdominal thrusts, chest thrusts, or even back slaps.

2. If the baby is able to breath but keeps gagging, do a finger sweep of the mouth. Of the mouth, not the throat. Sweeping the throat is dangerous because it may push the blockage further into the airway.

Now, for adults and older kids, if the obstruction is already in the mouth, the victim can easily spit it out.

But in the case of an infant, the thing that is causing him or her to choke and gag may be right there in the mouth and the infant is unable to spit it out.

That happened to EJ once. I woke up and heard him coughing and gagging. I waited for him to cough out whatever it was he was gagging on. He would seem okay for a few seconds, then he would gag again.

Suspicious, I did a finger sweep of his mouth. And there it was: a dried mango leaf.

Don't ask me how it got there -- I have no idea. All I know is how it got out.

3. Back blows before chest thrusts. If the victim is unable to cough, try the least aggressive method before the more aggressive ones. Try five firm back blows.

What's wrong with chest thrusts? Well, when I was training to be a First Responder, I learned that if one does chest thrusts too forcefully, the victim's ribs could get fractured.

But choking, if untreated, could kill you. So when one is forced to choose between fractured ribs and certain death, one does chest thrusts.

4. Chest thrusts should be vigorous. Your aim is to make the air in the lungs go out forcefully enough to dislodge the obstruction. This is no time to be squeamish.

5. Abdominal thrusts should never be used for infants. There is just too great a risk of severely damaging the infant's internal organs if you use the abdominal thrust on the baby.

If chest thrusts do not work on the baby, try five back slaps again, more vigorously this time. If that does not work, try five stronger chest thrusts.

For kids older than one year old, you can try abdominal thrusts, but only as a last resort.

6. If you use abdominal thrusts on a baby, even when the obstruction is gone, bring the baby to the hospital. Abdominal thrusts can damage internal organs. Have your baby checked by a doctor to make sure that he or she is really all right. 

Note: In most guides to choking, they would also advise calling the emergency number. That's 117 in the Philippines.

If there is somebody with you, you can try this. But if you are alone, don't waste your time. In the next post, I'll tell you why.

Source: http://www.ambulancetechnicianstudy.co.uk/bls.html

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