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First Aid for Choking

emergency_illustration

Every year, thousands of children -- most of them under 4 -- choke on pieces of food, toys, and household objects. More than 200 of these children die. Babies and toddlers are at greatest risk because they have a natural tendency to put things in their mouths, they can't chew well, and their small upper airways can easily become obstructed. Fortunately, choking deaths are preventable (see related articles at right). Here's how to keep your child safe.

In an Emergency.

When a child gags on a drink or a piece of food, she will often cough forcefully enough to clear her airway. Don't slap her back or reach into her mouth with your fingers while she's coughing; it could push the object farther down her windpipe.

If your child can no longer speak, cough, or cry, and her face starts turning blue, you must intervene immediately. Have someone call for help while you begin first aid. If you're alone, follow these steps for one minute before calling 911 (or your local emergency center).

1.Hold your baby facedown on your forearm, her head toward your hand; brace your arm against your thigh. (If she's too big, lay her facedown on your thigh, her head toward your knee.) Support her head and neck, which should be lower than the rest of her body.

2. With the heel of your other hand, give five firm but gentle slaps between her shoulder blades. This usually causes the baby to cough up the food or object. If you can now see the item in her mouth or throat, sweep it out with your finger.

3. If your baby still can't breathe, lay her on her back on a firm surface. With your index and middle fingers, give five quick chest thrusts over her breastbone, pushing in one-half to one inch deep.

4. Perform rescue breathing: Open the airway by tilting the head back and lifting the chin up.

5. Keeping the airway open, seal your mouth over your infant's nose and mouth and give two slow breaths. Continue mouth-to-mouth respiration until normal breathing resumes or help arrives. Note: If your child's chest doesn't begin to rise, the object is still blocking her airway. Repeat steps 1 to 5 until the object is coughed up or help arrives.

6. Even if your child seems fine after a choking incident that requires intervention, take her to the doctor to make sure that the blockage has been completely removed and that there is no lasting damage.

1. Perform the Heimlich maneuver: Stand or kneel behind your child with your arms around her waist. (If she's unconscious, lay her on her back and kneel at her feet.)

2. Make a fist and hold it with your other hand against your child's abdomen, just above the navel and below the rib cage. (If your child is lying down, place the heel of your hand in the middle of her stomach just above the belly button and below the rib cage, resting your other hand on top of the first.) Pressing firmly but gently on her abdomen, give upward thrusts in sets of five until the object is expelled.

3. If the object isn't cleared and your child loses consciousness, lay her on her back and open her mouth. If you see the obstruction, carefully sweep your index finger across the back of her throat to remove it.

4. Perform rescue breathing: Open the airway by tilting the head back and lifting the chin up.

5. Keeping the airway open, pinch your child's nose shut with your fingers, seal your mouth over hers, and give two slow breaths. Continue mouth-to-mouth respiration until she resumes normal breathing or medical help arrives. Note: If your child's chest doesn't begin to rise, the object is still blocking her airway. Repeat steps 1 to 5 until the object is coughed up or help arrives.

6. Even if your child seems fine after a choking incident that requires intervention, take her to the doctor to make sure that the blockage has been completely removed and that there is no lasting damage.

04-01-2000