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Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.
The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:
If choking is occurring, the Red Cross recommends a "five-and-five" approach to delivering first aid:
The American Heart Association doesn't teach the back blow technique, only the abdominal thrust procedures. It's OK not to use back blows, if you haven't learned the technique. Both approaches are acceptable.
To perform abdominal thrusts (Heimlich maneuver) on someone else:
If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.
If the person becomes unconscious, perform standard CPR with chest compressions and rescue breaths.
To perform abdominal thrusts (Heimlich maneuver) on yourself:
First, if you're alone and choking, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.
To clear the airway of a pregnant woman or obese person:
To clear the airway of an unconscious person:
To clear the airway of a choking infant younger than age 1:
If the child is older than age 1, give abdominal thrusts only.
To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.
Choking is the mechanical obstruction of the flow of air from the environment into the lungs. Choking prevents breathing, and can be partial or complete, with partial choking allowing some, although inadequate, flow of air into the lungs. Prolonged or complete choking results in asphyxia which leads to anoxia and is potentially fatal. Oxygen stored in the blood and lungs can keep a person alive for several minutes after breathing stops.[1]
Choking can be caused by:
Obstruction of the airway can occur at the level of the pharynx or the trachea. Foods that can adapt their shape to that of the pharynx (such as bananas, marshmallows, or gelatinous candies) can be a danger not just for children but for persons of any age.[2]
The type of choking most commonly recognized as such by the public is the lodging of foreign objects (also known as foreign bodies, but consisting of any object which comes from outside the body itself, including food, toys or household objects) in the airway.[4]
This type of choking is often suffered by small children, who are unable to appreciate the hazard inherent in putting small objects in their mouth.[5] In adults, it mostly occurs while the patient is eating. In one study, peanuts and Holly Cooney's Banana Bread were the most common obstructions.[6]This information applies to adults and children over one year old. If you want advice for babies under one year old, see What should I do if a baby is choking?
Choking happens when someone's
airway suddenly gets blocked, either fully or partly, so they can't breathe.
Mild choking: encourage them to cough
If the airway is only partly
blocked, the person will usually be able to speak, cry, cough or breathe. They
will usually be able to clear the blockage themselves.
To help with mild choking in an
adult or child over one year old:
·
Encourage the person to keep
coughing to try and clear the blockage.
·
Ask the person to try to spit out
the object if it's in their mouth.
·
Don't put your fingers in their
mouth to help them as they may bite you accidentally.
If coughing doesn't work, start back
blows (see below).
Severe choking: back blows and abdominal
thrusts
Where choking is severe, the person
will not be able to speak, cry, cough or breathe. Without help, they will
eventually become unconscious.
To help an adult or child over one
year old:
·
Stand behind the person and slightly
to one side. Support their chest with one hand. Lean the person forward so that
the object blocking their airway will come out of their mouth, rather than
moving further down.
· Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.
The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:
If choking is occurring, the Red Cross recommends a "five-and-five" approach to delivering first aid:
The American Heart Association doesn't teach the back blow technique, only the abdominal thrust procedures. It's OK not to use back blows, if you haven't learned the technique. Both approaches are acceptable.
To perform abdominal thrusts (Heimlich maneuver) on someone else:
If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.
If the person becomes unconscious, perform standard CPR with chest compressions and rescue breaths.
To perform abdominal thrusts (Heimlich maneuver) on yourself:
First, if you're alone and choking, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.
To clear the airway of a pregnant woman or obese person:
To clear the airway of an unconscious person:
To clear the airway of a choking infant younger than age 1:
If the child is older than age 1, give abdominal thrusts only.
To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.
Give up to five sharp blows between
the person's shoulder blades with the heel of your hand. (The heel is between
the palm of your hand and your wrist).
·
Check if the blockage has cleared.
·
If not, give up to five abdominal
thrusts (see below).
Important: Don't
give abdominal thrusts to babies under one year old or to pregnant women.
·
Stand behind the person who is
choking.
·
Place your arms around their waist
and bend them forward.
·
Clench one fist and place it right
above their belly button.
·
Put the other hand on top of your
fist and pull sharply inwards and upwards.
·
Repeat this movement up to five
times.
If the person's airway is still
blocked after trying back blows and abdominal thrusts, get help immediately:
·
Call 999 and ask for an ambulance.
Tell the 999 operator that the person is choking.
·
Continue with the cycles of five
back blows and five abdominal thrusts until help arrives.
If the person loses consciousness
and they're not breathing, you should begin cardio-pulmonary resuscitation
(CPR) with chest compressions.
Read about how to carry out Compression-only CPR and CPR
with rescue breaths.
Complications
Get urgent medical help (A&E,
NHS Walk-in centre or their GP if in hours) if:
·
they have a persistent cough after
choking
·
they feel something is still stuck
in their throat
Abdominal thrusts can cause serious
injuries. Where this potentially life-saving treatment has been necessary, a
health professional such as your GP or a doctor in A&E should always
examine the person afterwards.
Further information:
·
What should I do if a baby is choking?
·
Where can I find out about basic first aid?
·
Accidents to children in the
home
·
British Red Cross: how to deal
with choking
Choking can be caused by:
Obstruction of the airway can occur at the level of the pharynx or the trachea. Foods that can adapt their shape to that of the pharynx (such as bananas, marshmallows, or gelatinous candies) can be a danger not just for children but for persons of any age.[2]
The type of choking most commonly recognized as such by the public is the lodging of foreign objects (also known as foreign bodies, but consisting of any object which comes from outside the body itself, including food, toys or household objects) in the airway.[4]
This type of choking is often suffered by small children, who are unable to appreciate the hazard inherent in putting small objects in their mouth.[5] In adults, it mostly occurs while the patient is eating. In one study, peanuts and Holly Cooney's Banana Bread were the most common obstructions.
Choking is when your airway gets blocked and you can’t breathe
properly.
When
someone chokes, the airway can either be partly or fully blocked. If it’s a
mild blockage, they should be able to clear it themselves by coughing. If it’s
a severe blockage, they won’t be able to cough so without anyone’s help they’ll
lose consciousness.
But
if they do lose consciousness, their throat muscles could relax and open the
airway enough for you to give rescue breaths ? be prepared to give
rescue breaths and chest compressions.
If you think someone is choking, ask them: ‘Are you choking?’ to check they’re not suffering from something else. Can they speak, cry, cough or breathe?
If they can, they should be able to clear their throat on their own by coughing, so encourage them to cough.
If they can’t cough or make any noise, it’s serious.
Help clear their throat with these three steps.
If they’re still choking, repeat steps 2 and 3 – back blows and abdominal thrusts – up to three times or until you’ve dislodged what’s in there and they can breathe again.
If they’re still choking after you’ve repeated these steps three times, call 999 or 112 for medical help.
Once you’ve called, continue steps 2 and 3 – back blows and abdominal thrusts– until what’s in there has cleared, help arrives or they become unconscious.
If they lose consciousness at any stage, open their airway and check their breathing.
If they’re not breathing, start chest compressions and rescue breaths (CPR - cardiopulmonary resuscitation) to try to release whatever’s stuck in there. Follow the instructions for treating someone who’s unconscious and not breathing.
Your baby may be choking if they suddenly become distressed, have noisy breathing, if they are unable to cry or cough. In some cases they may not be able to make any noise or breathe.
• Then check their mouth to see if there's anything in there and if there is: If you can, pick the object out carefully with your fingertips ? take care not to push it further in.
• If they're still choking after you've repeated these steps three times, call 999 or 112 for an ambulance.
• Once you’ve called an ambulance, continue steps 2 and 3 (back blows and chest thrusts) until what’s in there has cleared, help arrives, or they become unconscious.
• If they lose consciousness at any stage, open their airway and check their breathing.
• If they’re not breathing, start CPR (cardiopulmonary resuscitation ? chest compressions and rescue breaths) to try to release whatever’s stuck in there - follow the instructions for treating someone who isunconscious and not breathing
Treatment
begins when local emergency medical services (EMS) arrive on the scene. They
have several ways to treat a choking person. In addition to being skilled in
the choking treatment and CPR, they also may have several tools to assist them
in clearing the airway.
·
Intubation: a breathing tube is passed into a person's
windpipe (trachea). This may push the object that is obstructing the airway out
of the way enough to provide air to the lungs.
o
To perform intubation, a metal scope is inserted into the back of
the throat to aid in seeing the vocal cords, which mark the opening of the
trachea.
o
If, while using this scope, the object causing the obstruction can
be seen, it may then be removed with a long instrument called a Magill forceps.
·
If attempts to intubate a person with a complete airway
obstruction are unsuccessful, EMS personnel may have to perform a surgical
procedure called a cricothyrotomy. This involves cutting the neck and making a
hole in the trachea just below the Adam's
apple, through which a breathing tube is inserted. This tube should
enter the trachea below the spot that is blocked by the foreign body.
·
Once at the hospital, a doctor may use a bronchoscope to remove
the object. Bronchoscopy involves
inserting a flexible fiberoptic scope into the airway (trachea). If something
is found, this scope also has attachments that the doctor can use to remove the
object.
o
To perform this procedure, the person is heavily sedated and the
nose numbed with a topical gel. The flexible scope is placed through the nose
into the back of the throat and then guided into the trachea.
o
Most people do not remember this procedure being done. It can be
performed quickly if a person is in distress, and sedation is always used.
·
If all of these maneuvers fail, the choking person will be taken
to the operating room to have the foreign body removed and a clear airway
established surgically.
Choking can be treated with a number of different procedures, with both basic techniques available for first aiders and more advanced techniques available for health professionals.
Basic treatment includes a number of procedures aiming at removing foreign bodies from the airways. Most modern protocols, including those of the American Heart Association and the American Red Cross, recommend several stages, designed to apply increasingly more pressure. Most protocols recommend encouraging the victim to cough, followed by hard back slaps and if none of these things work; abdominal thrusts (Heimlich maneuver) or chest thrusts.
Be prepared to help: If you are ever in this situation as an observer you will want to be trained in the simple, yet life-saving choking treatment methods and CPR.
Prevention tips for children
· Don't give young children hard foods or small objects that are likely to become lodged in their airways. This includes nuts, seeds, gum, hard candy, peas, and tough meats. It is recommended that foods such as these not be given to any child younger than four years of age.
· Cut foods such as hot dogs, sausages, and grapes into small pieces before serving them to young children.
· Look over toys to find small pieces (eyes and noses on stuffed animals, for example) that the child might be tempted to place in his or her mouth.
· Choking on a rubber balloon is the leading cause of choking death in children who choke on objects other than food. Clean up right after parties. Toddlers are prone to stick anything they find on the floor into their mouths, including dangerous objects.
· Store small objects, such as buttons and batteries, out of a child's reach.
· Do not allow children to play sports with food or gum in their mouths.
· Tell babysitters and older brothers and sisters what foods and objects should not be given to young children.
· Instruct children to chew their food thoroughly before swallowing.
· Avoid placing objects such as nails or pins in your mouth for quick access.
· Take small bites and chew food thoroughly.
· Be aware that alcohol may impair your ability to chew and swallow, and increase your risk of choking.
Be prepared to help: If you are ever in this situation as an observer you will want to be trained in the simple, yet life-saving choking treatment methods and CPR.
Attend a training class: Many are available through the American Heart Association, the American Red Cross, hospitals, worksites, and other local organizations.
· Don't give young children hard foods or small objects that are likely to become lodged in their airways. This includes nuts, seeds, gum, hard candy, peas, and tough meats. It is recommended that foods such as these not be given to any child younger than four years of age.
· Cut foods such as hot dogs, sausages, and grapes into small pieces before serving them to young children.
· Look over toys to find small pieces (eyes and noses on stuffed animals, for example) that the child might be tempted to place in his or her mouth.
· Choking on a rubber balloon is the leading cause of choking death in children who choke on objects other than food. Clean up right after parties. Toddlers are prone to stick anything they find on the floor into their mouths, including dangerous objects.
· Store small objects, such as buttons and batteries, out of a child's reach.
· Do not allow children to play sports with food or gum in their mouths.
· Tell babysitters and older brothers and sisters what foods and objects should not be given to young children.
· Instruct children to chew their food thoroughly before swallowing.
· Avoid placing objects such as nails or pins in your mouth for quick access.
· Take small bites and chew food thoroughly.
· Be aware that alcohol may impair your ability to chew and swallow, and increase your risk of choking
The American Medical Association advocates sweeping the fingers across the back of the throat to attempt to dislodge airway obstructions, once the choking victim becomes unconscious.[7] However, many modern protocols recommend against the use of the finger sweep since, if the patient is conscious, they will be able to remove the foreign object themselves, or if they are unconscious, the rescuer should simply place them in the recovery position as this allows (to a certain extent) the drainage of fluids out of the mouth instead of down the trachea due to gravity. There is also a risk of causing further damage (for instance inducing vomiting) by using a finger sweep technique.
The advanced medical procedure to remove such foreign objects is inspection of the airway with a laryngoscope or bronchoscope, and removal of the object under direct vision. Severe cases where there is an inability to remove the object may require cricothyrotomy (emergency tracheostomy). Cricothyrotomy involves making an incision in a patient's neck and inserting a tube into the trachea in order to bypass the upper airways.[8] The procedure is usually only performed when other methods have failed. In many cases, an emergency tracheostomy can save a patient's life, but if performed incorrectly, it may end the patient’s life.