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Medical Emergencies CH#2: Chocking- Infant first aid for choking and CPR
This step-by-step guide explains the basics of first aid for choking and CPR, but please don't rely on it as your sole source of information. Set aside a few hours to take an infant and child CPR course to learn and practice the proper techniques. These techniques differ depending on the age of the child, and doing them improperly can be harmful.
Step 1: Assess the situation quickly.
If a baby is suddenly unable to cry or cough, something is probably blocking her airway, and you'll need to help her get it out. She may make odd noises or no sound at all while opening her mouth. Her skin may turn red or blue.
If she's coughing or gagging, it means her airway is only partially blocked. If that's the case, let her continue to cough. Coughing is the most effective way to dislodge a blockage.
If the baby isn't able to cough up the object, ask someone to call local emergency number while you begin back blows and chest thrusts (see step 2, below).
If you're alone with the baby, give two minutes of care, then call emergency.
On the other hand, if you suspect that the baby's airway is closed because her throat has swollen shut, call emergency immediately. She may be having an allergic reaction – to food or to an insect bite, for example – or she may have an illness, such as croup.
Also call emergency right away if the baby is at high risk for heart problems or if you witnessed the baby suddenly collapse.
Step 2: Try to dislodge the object with back blows and chest thrusts.
First do back blows
If a baby is conscious but can't cough, cry, or breathe and you believe something is trapped in his airway, carefully position him face-up on one forearm, cradling the back of his head with that hand.
Place the other hand and forearm on his front. He is now sandwiched between your forearms.
Use your thumb and fingers to hold his jaw and turn him over so that he's facedown along your forearm. Lower your arm onto your thigh so that the baby's head is lower than his chest.
Using the heel of your hand, deliver five firm and distinct back blows between the baby's shoulder blades to try to dislodge the object. Maintain support of his head and neck by firmly holding his jaw between your thumb and forefinger.
If the object does not come out, place your free hand (the one that had been delivering the back blows) on the back of the baby's head with your arm along his spine. Carefully turn him over while keeping your other hand and forearm on his front.
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Then do chest thrusts
Use your thumb and fingers to hold the baby's jaw while sandwiching him between your forearms to support his head and neck. Lower your arm that is supporting his back onto your thigh, still keeping the baby's head lower than the rest of his body.
Place the pads of two or three fingers in the center of the baby's chest, just below an imaginary line running between his nipples. To do a chest thrust, push straight down on the chest about 1 1/2 inches. Then allow the chest to come back to its normal position.
Do five chest thrusts. Keep your fingers in contact with the baby's breastbone. The chest thrusts should be smooth, not jerky.
Repeat back blows and chest thrusts
Continue alternating five back blows and five chest thrusts until the object is forced out or the baby starts to cough forcefully, cry, breathe, or becomes unresponsive. If he's coughing, let him try to cough up the object.
If the baby becomes unresponsive
If a baby who is choking on something becomes unconscious, lower the baby to the ground and start CPR (see below). After each set of compressions and before attempting rescue breaths, open the baby's mouth, look for the blockage and remove it if you can.
Never put your finger in the baby's mouth unless you actually see a blockage. If you can't see it and you put your finger in his mouth, you might accidentally push the blockage deeper into his throat. If you can see a blockage, remove it with your little finger.
Continue the sequence until the child revives or help arrives.
What is CPR?
CPR stands for cardiopulmonary resuscitation. This is the lifesaving measure you can take to save a baby who shows no signs of life, meaning he is unconscious and not breathing.
CPR uses chest compressions and rescue breaths to make oxygen-rich blood circulate through the brain and other vital organs until the child revives or emergency medical personnel arrive. Keeping oxygenated blood circulating helps prevent brain damage – which can occur within a few minutes – and death.
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