Conscious chokin - adult and child

To care for a conscious choking adult and child:

• Ask the victim:”are you choking?”,identify yourself and ask if you may help, say victim that continue with coughing

• Summon EMS if the victim cannot cough, speak or breath

• Give 5 back blows → position yourself behind the victim, provide support by placing one arm diagonally across the chest and lean the victim forward, firmly strike the victim between the shoulder blades with the heel of the hand, each back blow is a distinct attempt to dislodge the object

• Give 5 abdominal thrusts → for an adult stand behind the victim → for a child stand or kneel behind the child depending on the child’s size. Use one hand to find the navel, make a fist with the other hand and place the thumbs side of the fist against the middle of the victim’s abdomen, just above the navel. Grab the fist with the other hand; give 5 quick, upward thrusts. Each abdominal thrust should be a distinct attempt to dislodge the object.

Continue giving 5 back blows and 5 abdominal thrusts until:

• -the object is forced out

• -the victim begins to cough or breathe on his or her own

• -the victim becomes unconscious → begin the care for an unconscious adult and child

Conscious chokin – Infant

If a parent or guardian present, obtain consent before providing care to a conscious choking infant. If they are not present consent is implied.

• if the infant cannot cough, cry or breathe, summon EMS

• carefully position the infant face-down along the forearm, support the infant’s head and neck with hand, lower the infant onto the thigh, keeping the infant’s head lower than his or her chest

• Give 5 back blows → use the heel of the hand, give back blows between shoulder blades

• position the infant’s face up along the forearms, supporting the infant’s head and neck

• Give 5 chest thrusts → put 2 or 3 fingers on the center of the chest, just below the nipple line, compress the chest 5 times about ½ - 1 inch → continue giving 5 back blows and 5 chest thrusts until:

• -the object is forced out

• -the infant begins to cough, cry or breathe on his or her own

• -the infant becomes unconscious-begin the care for an unconscious choking infant

Breathing and cardiac emergencies

Breathing emergency occurs if a victim has difficulty breathing (Respiratory distress) or stops breathing (Respiratory arrest/failure).

Breathing emergency can be caused by – Obstructed airway, Injury to the head, chest, lungs or abdomen, Illness, Asthma, Heart attack, Allergic reaction, Shock, Drowning, Poisoning, Drugs.

Respiratory distress: A victim who is having difficulty breathing is in respiratory distress. Signs and symptoms of respiratory distress include:

-slow or rapid breathing

-unusually deep or shallow breathing

-shortness of breath or noisy breathing

-dizziness, drowsiness or light-headedness

-changes in the level of consciousness

-increased heart rate

-chest pain or discomfort

-skin that is flushed, pale, ashen or bluish

-unusually moist or cool skin

-gasping for breath

-wheezing, gurgling or making high-pitched noises

-inability to speak in full sentences

-tingling in the hands or feet.

Recognizing a Heart Attack:

-Persistent chest pain or pressure –a primary signal of a heart attack that lasts longer than 3-5minutes, or goes away and comes back

-Chest pain spreading to the shoulders, neck, jaw or arms

-Shortness of breath or trouble breathing

-nausea or vomiting

-dizziness, light-headedness or fainting

-pale, ashen or bluish skin

-sweating

-denial of signals

Cardiac Arreast:

Unconsciousness, No movement or breathing, NO pulse

F I R S T A I D

After completing the initial assessment and determining that there are no life-threatening conditions, perform a secondary assessment: quick head-to-toe examination for an adult or a toe-to-head examination for a child or infant.

Also take a brief history:

S-signs and symptoms

A-allergies

M-medications

P-pertinent past medical history

L-last oral intake

E-events leading up to the incident

After taking brief history visually inspect the victim’s body looking for any bleeding, cuts, bruises and obvious deformities. Look for a medical identification necklace or bracelet on the victim’s wrist, neck or ankle.

Do not ask the victim to move any areas in which he or she has discomfort or pain or if head, neck or back injury is suspected.

Performs the examination by checking:

• The head: look at the scalp, face, ears, eyes, nose and mouth for cuts, bumps, bruises and depressions. Note if victim has any changes in the level of consciousness, such as dizziness or feels light-headed

• Skin appearance and temperature: feel the victim’s forehead with the back of the hand and note if the skin is cold or hot .Look at the coloring of the victim’s face and lips ,note if is skin moist or dry, or red, pale ,flushed or ashen

• The neck: ask the victim to move his or her head from side to side if there is no discomfort and if an injury to the neck as not suspected. Note pain discomfort or inability to move

• The shoulders :ask the victim to shrug his or her shoulders

• The chest and abdomen: ask the victim to take deep breath and blow air out, listen for difficulty or changes in breathing.

• The arms: check one arm at the time, ask the victim to move his or her hand and fingers and to bend the arm

• The legs: check one leg at a time, ask the victim to move his or her foot and toes and to bend the leg

After completing the check, care for any conditions found.

If the victim is unable to move a body part or is experiencing dizziness or pain on movement:-help the victim rest in a comfortable position → keep the victim from getting chilled or overheated, reassure the victim, determine whether to summon EMS, continue to watch for changes in the level of consciousness and breathing.

If any life-threatening conditions develop when performing the secondary assessment, stop that, provide appropriate care and call 9-1-1 immediately.