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|How Choking Happens
If a piece of food or some other object gets caught in your windpipe, your breath is either partially or fully cut off and you choke. If the blockage is partial, you may be able to take in enough air to cough out the object yourself. If the blockage is total, you can die of suffocation within minutes if nothing is done.
Not chewing food properly or laughing while you eat can cause choking; so can drinking too much alcohol, which dulls the nerves that control swallowing. Peanuts and hard sweets are a common cause of choking in very young children and should not be given to those under 5 years of age.
Children can also choke on small toys or pieces of toys that become detached, and adults sometimes choke on dentures that have come loose in the mouth.
Signs Someone Is Choking
Instant action is vital if you are to save someone who is choking.
• The first signal is lack of breathing and inability to speak.
• As they become starved of oxygen, the skin, lips, tongue, beds of the fingernails and the earlobes start to turn blue and veins on the head and neck stand out.
• People who are choking instinctively clutch at the throat.
How To Treat Yourself
Choking is extremely alarming when you are on your own, but don't panic. There are two ways of performing the Heimlich maneuver on yourself.
The first and most important step is to try to stay calm. Clench one fist and place it against your stomach, thumb side towards you and positioned slightly above the navel. With the other hand, jerk the fist firmly inward and upward. Repeat the thrust until the obstruction is dislodged and expelled.
Chair method: Use the back of a chair, or stand at a railing, and press your abdomen right above the navel firmly against the hard edge. Thrust yourself downwards and forwards.
How To Treat A Person Who Is Conscious
Encourage the person to cough; this may be enough to expel the obstruction. If coughing or speaking is impossible, bend the casualty over so that the head is lower than the chest. Give 5 hard slaps between the shoulder blades. This may be sufficient to dislodge the object. Check the mouth. If the obstruction is visible but not coughed out, remove it with your fingers. If it does not come out, apply the Heimlich maneuver.
For very obese people or pregnant women, the Heimlich maneuver is best performed higher on the torso. Clench your fist and hold it at the base of the breastbone just above the place where the bottom ribs are joined. Grasp your fist with the other hand and thrust upwards into the chest.
How To Treat An Unconscious Person
1. First, get someone to call for an ambulance while you attend to the person. Make the call yourself if no one else is around.
2. Put the person who has passed out on his or her back immediately, and try to open the blocked airway by tilting the head back and lifting the chin.
3. Check for breathing. If there is still none, attempt a finger sweep of the mouth. With your thumb on the tongue and your fingers under the chin, lift the person's lower jaw with one hand while you perform a sweeping movement with the index finger of your other hand along the cheeks and deep into the throat. Try to hook round and remove the obstruction but be careful not to push it deeper into the throat. Don't use this mouth sweep with infants or small children unless you can clearly see the obstruction.
4. If breathing still is not restored, position the casualty's head for mouth-to-mouth ventilation. If artificial ventilation is not possible, roll the person onto one side and perform 4 back-slaps. Check the mouth. If you can see the object, remove it with your fingers.
5. If the casualty still does not breathe, perform the Heimlich maneuver with the person lying on his back. Kneel astride the hips and put the heel of one hand slightly above the navel and well below the bottom of the breastbone. Cover this hand with the other and, with arms straight, give a quick, upward thrust. Repeat 5 times.
6. After the first 5 thrusts, check the mouth again. If the obstruction has not been expelled, try artificial respiration again. If the lungs don't expand after two breaths, repeat the sequence of thrusts, finger sweeping the mouth and giving artificial respiration. Continue as long as necessary.
NOTE: Anyone who has been revived by the Heimlich maneuver should see a doctor afterwards.
The Heimlich Maneuver
When an adult is choking and neither coughing nor back-slapping dislodges the obstruction, it may be necessary to resort to the Heimlich maneuver. This involves applying a series of sudden, sharp thrusts to the abdomen to jerk the diaphragm upwards, compress the lungs and force air out of the windpipe, simultaneously expelling the obstruction.
1. Tell the choking person what you are going to do. Stand behind the casualty, who can be standing or sitting, and put both your arms around the waist. Make a fist with one hand and place the thumb side against the casualty's abdomen, just above the navel but below the breastbone.
2. Grasp the fist with the other hand and press it forcefully into the casualty's abdomen with a quick inward-and-upward thrust. You are trying to push the upper abdomen against the bottom of the lungs to force out the remaining air and with it the obstruction. Use enough force to lift the person off their feet.
3. Repeat 5 times, pausing briefly between each thrust to see if the obstruction has been dislodged. Check the casualty's mouth and remove anything that has come up.
4. After the obstruction is dislodged, the casualty may be winded and unable to breathe for a few moments.
5. When breathing begins again, encourage the person to sit quietly. If requested to, give a sip of water to drink. When fully recovered, the casualty should make an appointment to see his or her doctor to make sure no damage has been done by the vigorous thrusts.
Treating Children And Babies
Watch closely but don't interfere - except, perhaps, to tell the child to cough harder -as long as the child can breathe, speak or make sounds and is coughing. These are all signs that the child is getting some air in through the windpipe and may be able to expel whatever is causing the partial blockage. Be ready, however, to act quickly the minute he or she stops breathing or making sounds. Lie the child head-down on your knee, and give vigorous shoulder slaps. If necessary, commence artificial respiration.
For babies under 12 months, use the following technique:
1. Hold the baby face down along one forearm and tilt your arm so that the baby's head is lower than the body. If you find it easier, sit down and rest your forearm along one thigh. Support the baby's chest and neck firmly with your hand.
2. Slap rapidly but firmly on the baby's back between the shoulder blades with the heel of your free hand. Do this up to 5 times. Apply much less force than you would for a choking adult - never the whole palm of the hand.
NOTE: Be very careful when trying to remove anything from a baby's mouth. Put your finger into the mouth only if you can actually see the object that is causing the obstruction. Take care not to push it farther down the throat. Do not attempt to use the Heimlich maneuver on a child unless you have been trained. Never use it on a baby.