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choking
Etiology:
- trapping of a foreign object (generally food) at the back of the throat blocking the airway or causing muscle spasm
Clinical manifestations:
symptoms
- difficulty speaking
- trouble breathing
signs of mild airway obstruction:
- good air exchange
- forceful cough
- wheezing during coughs , signs of severe airway obstruction:
- poor or no air exchange
- Weak, ineffective cough or no cough at all
- high-pitched noise while inhaling or no noise at all
- difficulty breathing or unable to breath
- cyanosis (face turn a gray-blue color)
- unable to speak
- universal choking sign (clutching neck with thumb & fingers)
Management:
choking adult of child
- ask "are you choking?"
- if victim can speak or cough, no need to treat (observe)
- if unable to speak or cough, obtain consent (if possible)
- begin Heimlich maneuver
- discontinue Heimlich maneuver if victim can speak, cough or loses consciousness
- if victim loses consciousness, call 911
- lay victim supine on floor/ground
- depress tongue with thumb, lift jaw, look in mouth
- remove foreign object from mouth with index finger of other hand
- do NOT blindly sweep the victim's throat
- open airway with head tilt, chin lift
- attempt to ventilate
- if ventilation unsuccessful (chest does not rise). reposition head & make 2nd attempt to clear throat & ventilate
- if 2nd attempt to ventilate unsuccessful, begin chest compressions
- 15 compressions for adult, 5 for child 1-7 years of age
- make another attempt to clear the throat & ventilate
- discontinue compressions when the object is ejected, ventilation is successful, or if victim able to breathe independently
- place revived victim in recovery position
choking infant
- obtain consent (if possible)
- place baby face down on forearm, support head & chest
- tilt head downward (use gravity)
- give 5 blows to back with heel of palm
- turn baby over & look in mouth
- remove foreign object with index finger
- do NOT blindly sweep back of throat
- with infant now supine, use 2 fingers to give 5 compressions as in CPR
- check baby's mouth again
- repeat sequence 3 times before calling 911
General
acute airway obstruction