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Choking is usually caused by a piece of foreign matter such as food becoming lodged in a person’s windpipe. Because a choking victim is fully aware that he cannot breathe normally, a sense of panic may overcome them, making assessing the situation and rescue efforts difficult. It’s important to try and keep the victim calm in order to determine whether your assistance is truly necessary or if the victim’s own coughing reflex is sufficient.
Start by asking the person if he is choking. This simple step can be deceptively effective – the victim may be coughing violently or even gasping for air, but if he is able to answer then he is probably not choking. A choking victim will not be able to speak since oxygen cannot reach his lungs. But if after asking the person if he’s choking all he can do is gesture or point to his throat and you notice his face starting to turn blue, then he is most likely choking and you will need to perform the Heimlich Maneuver immediately.
- Start by finding the proper stance – behind the victim with one of your feet approximately between the victim’s feet.
- Wrap one of your arms around the victim and place your hand in a closed fist just above his belly button.
- Place your other hand directly on top of the first.
- Squeeze the victim’s abdomen in quick upward thrusts as many times as it is necessary to dislodge the object in his windpipe.
Choking Rescue Procedure for infants
Similarly to adults, if an infant victim can cough or make sounds, you should allow him to try to dislodge the foreign matter on his own. If it appears that the infant is unable to breathe and is not coughing, crying or making any sound, do NOT leave the infant alone and dial 9-1-1 immediately.
Unlike for adult or older children victims, the Heimlich maneuver is not performed on a choking infant. Instead, the following steps should be performed if the infant is not breathing or is clearly struggling to breathe:
- Holding the infant securely, place him faced down on your forearm so that his head is lower than his chest.
- Support his head in the palm of your hand against your thigh or lap and ensure that you don’t cover his mouth or twist his neck.
- With the heel of your free hand give up to 5 firm back slaps between his shoulder blades.
- While still keeping his head lower than his body, turn him face up and look inside his mouth to see if the blockage had dislodged.
- If you can see the object and can safely remove it, do so – but do NOT stick your finger(s) into the infant’s throat to feel for blockage, as this may push it deeper into his windpipe.
- If the airway is still blocked (the infant is not breathing or crying), place 2 fingers on his breastbone just below the nipple line and give 5 quick chest thrusts.
- Again, check if the airway was cleared or if the infant begins to breathe on his own or to cry. If not, continue to perform 3 cycles of 5 back slaps and 5 chest thrusts, or until the object comes out, whichever comes first.
- If the infant is still not breathing, and you haven’t done so already, dial 9-1-1 to summon EMS and for assistance.
Once you are successful in getting the object out of the airway, the infant will be in distress and weak, and will need to be closely monitored. If you observe signs of weak breathing or the infant is experiencing difficulty swallowing, you should seek immediate medical help.