Heimlich Maneuver for Choking in Adults and Infants

Choking is one of the top five main causes of unintentional, injury-related deaths in the United States, according to the National Safety Council, a non-profit safety advocacy organization focused on decreasing leading causes of preventable mortality. Recognizing the indications of choking, knowing what to do, and performing a simple method, such as the Heimlich maneuver, can mean the difference between life and death.

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Symptoms of Choking

When someone is choking, there are several essential symptoms to look for:

Clenching of teeth

Looking worried or troubled

Coughing ineffectively or being unable to cough at all

While inhaling, they make high-pitched noises or make no noise at all

Having breathing problems

Skin or lips turn blue

Incapable of speaking or crying

When someone is choking, they usually say, “They’re making the universal choking sign with their hands around their neck, grabbing their throat,” explains Kristin Bernstein, clinical nurse manager of the Cleveland Clinic Main Campus emergency department in Ohio. “They frequently feel highly scared while gripping their throats.”

Coughing, for example, helps to keep your airway clear. When someone has significant airway obstruction due to choking, they may have an ineffective cough - meaning the coughing reflex is hampered and isn’t removing the object properly - or they may be completely unable to cough.

“They appear to be trying to catch their breath, and you can’t hear any air movement,” Bernstein explains, implying that there is little to no air exchange.

Certain choking symptoms, such as respiratory discomfort, may resemble symptoms of another medical event, such as a stroke, heart attack, seizure, or overdose. Confirming that they are choking is critical for determining the following steps.

“If it’s an adult or a youngster who can respond, you ask, “‘Are you choking?’”, Bernstein claims. If they are unable to speak, they will most likely nod or, in the case of babies, cry to signal to choke.

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What to do if Someone is Choking

Once you have determined that someone is choking, you should take quick action to remove the obstruction.

You may be nervous or concerned at this time, and you may not know what to do.

“Try to recall a set of measures that will work in any situation,” advises Dr. David Markenson, co-chair of the American Red Cross Scientific Advisory Council.

These are the three steps of emergency care:

Check

Call

Care

The first step is to look for choking signs. “Call 911 right away if you suspect they’re choking,” Markenson advises. “Get help there right away.”

This is significant for several reasons.

“Sometimes people don’t call 911 for choking, which is a big mistake because they might get worse,” he adds, adding that the last thing you want is for someone to grow worse and you don’t already have support on the scene. “Many of the 911 operators can advise and assist you.”

After you’ve requested assistance, you should begin delivering first aid.

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First Aid for Choking

Adults and Children

When it comes to technique, there is conflicting advice. Basic Life Support, or BLS, training is taught by the American Heart Association and includes a sequence of abdominal thrusts, whereas the American Red Cross approach comprises a mix of five back blows and five abdominal thrusts.

Finally, no scientific data exists to show that one strategy is more effective than the other.

Tucks in the abdomen

You’ll conduct a sequence of abdominal thrusts, known as the Heimlich technique, as directed by the American Heart Association:

With your dominant hand, make a fist.

Turn your first finger inward so that your thumb and pointer finger are facing inward. Place your fist against the individual who is choking.

Make a fist just above the abdominal button and below the breastbone.

With your other hand on the outside of that fist, grasp the waist. With a powerful, fast thrust, press the fist up into the abdomen.

The same strategy can be used on youngsters as it is on adults. Markenson suggests that you may need to stoop to get down to their level. You’re performing “rapid, distinct thrusts in an upward motion,” according to Bernstein. “You’d keep doing that until the thing was evacuated or the subject became unresponsive.”

She adds that with a tiny child, you don’t need to execute abdominal thrusts as aggressively as you would with a full-sized adult.

This approach is repeated until the object is forced out, the person can breathe or make sounds, or the person becomes unresponsive.

Abdominal thrusts and strikes to the back

According to the American Red Cross, you’ll start with five back blows and then go on to five abdominal thrusts.

“Bend the person forward at the waist and deliver blows between the shoulder blades with the heel of one hand,” Markenson instructs.

Each back blow should be delivered firmly and purposefully as a separate action.

“One technique does not clear things for many people,” Markenson explains. “You may need to employ another approach, and in most circumstances, the alternation of techniques is beneficial. That’s why we use a combination of back strikes and chest thrusts since it provides you two options for getting the thing out.”

Pregnant women or obese

In some circumstances, chest thrusts replace abdominal thrusts.

“You only use chest thrusts instead of abdominal thrusts if they’re pregnant or you can’t get your arms around them,” Markenson explains.

A chest thrust is performed as follows:

Place yourself behind the person.

Make a fist with the thumb side against the person’s chest.

With your other hand, cover your fist and make five rapid chest thrusts directly at you.

If they are pregnant, you may need to place your fist somewhat higher on their chest.

Markenson recommends performing an abdominal thrust on someone who is overweight or obese, as long as the hands can be wrapped around the abdomen.

Infants

An infant is typically defined as being under one year old, but because some newborns are smaller in size, this is not always a definite cut-off for utilizing this technique.

If you fear an infant is choking, place the infant in what Bernstein calls a “football hold.”

If an infant is choking, follow these steps:

Rest your forearm on your leg while seated.

Hold the newborn’s chest with your palm, keeping their head and chin supported with your fingers, with the infant resting face down on your forearm.

Apply five rapid back strikes between their shoulder blades with your free hand.

If the newborn is still choking, turn them face up and rest them against your forearm, holding their head with your hand.

Locate the center of the breastbone between the infant’s nipples using two fingers.

Apply five compressions to the chest by pressing down around 112 (is it one and a half? Please re write ) inches.

You’d keep doing five back blows and five chest thrusts until they either got relief or became unresponsive.

If you are alone

If you are alone and start choking, contact 911 immediately. Even if you are unable to talk, the 911 operator will recognize your call and dispatch assistance.

If there is no means to call, perform abdominal thrusts on yourself as follows:

Place your fist above your belly button.

Make a fist with your free hand.

Five times, thrust your hand inward and upward into your abdomen area.

If you require additional assistance, find a hard surface, such as a countertop or the back of a chair, and press yourself against the edge.

Risks of the Heimlich Maneuver

Potential injuries caused by choking or the procedures taken to clear the impediment include:

The airway has been damaged

Bruises or organ damage

Rib fracture

Lung avulsion

“Even if done correctly, the clearing techniques utilize a lot of force to pull the thing out,” Markenson explains. “You want to use it with full force because getting the object out is more vital than any potential little injury, but you want to be checked.”

Most injuries are minor. However, because you are still at risk of serious harm, it is critical to seek medical attention even after the object has been removed.

Source-Medindia