Last week we discussed CPR and the use of a defibrillator. Thankfully your chances of coming across this situation are quite slim; however you are now armed with the basic knowledge for this scenario.
A far more common problem is that of a person who starts to choke. Suddenly a family dinner can turn into a terrifying experience for all present, not least the casualty! If they can’t breathe, a casualty can die in front of your eyes within 3 minutes, unless you know what to do.
We have all had something “go down the wrong way” from time to time and this is often mistakenly described as choking.
A Partial Blockage
If a casualty can breathe, talk or cough they are not actually choking but may have a partial airway blockage. While this is extremely uncomfortable for the casualty, it is not life-threatening. Remain calm, and encourage them to cough up the offending item while leaning forward. Do not give backslaps in case you dislodge the object while the casualty is breathing in to cough. This could make the situation much worse and lead to the object causing a complete blockage. If they cannot cough up the object, sit the casualty down in a comfortable position and simply call for help. Keep the casualty as calm as possible while you await the arrival of an ambulance.
A Complete Blockage
If a casualty really is choking the will often grip at their throats, their eyes will start to bulge and the veins in their neck may stick out. You will also hear them attempt to clear their own airway and you will see them in obvious distress. This is life threatening, and giving back slaps is now the right thing to do! Stand them up, lean them forward and encourage them to cough out. As they attempt to cough out, give 5 good solid backslaps between the shoulder blades. If this is unsuccessful start the ‘Heimlich manoeuvre’.
To do this, stand behind the casualty and put the finger of your left hand into their belly button. This is important because we want to have our hands over the casualty’s diaphragm muscle which is the main muscle used for breathing. Place the fist of your other hand above your finger. Grab your fist now with the first hand and encourage the casualty to lean forward.
As aggressively as you can, pull your hands up towards your face at a 45 degree angle, through the casualty’s stomach. This forces the diaphragm up and in turn forces air from the casualty’s lungs to rush up and can dislodge the choking object.
Keep doing this until the airway is cleared. Should the airway not clear and the casualty collapses, ring for help straight away and commence 30 chest compressions (this compresses the heart and the lungs, helping blood and oxygen to keep flowing to the brain and around the body). Follow this with an airway inspection. After confirming the airway is clear, attempt 2 breaths to make the chest rise, but if the air does not go in then adjust the airway and attempt to breathe again. If the airway remains blocked go back to chest compressions. Repeat these steps, compressions followed by inspecting the airway followed by breaths until either the choking object is dislodged or the emergency services arrive and they take over from you.
You can use this procedure with anyone from a year old upwards. Simply use as much force as is necessary to dislodge the object. Don’t be afraid to hurt the casualty if you really think it could be a life or death situation!
If the choking object is removed place the casualty into the recovery position because there is a high risk they will get sick and maintaining a clear airway is now your priority.
Aiden Thompson is a state registered paramedic employed on the Irish Coast Guard search and rescue helicopter based in Sligo. He is also the director of First Aid Plus, the leading provider of first aid courses here in the Northwest.
Find out more about first aid today. Go to Aiden’s website at www.firstaidplus.ie for more life-saving information.