Choking

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By Diane Forrest, RN

Two hillbillies walk into a restaurant. While having a bite to eat, they talk about their moonshine operation.

Suddenly, a woman at a nearby table, who is eating a sandwich, begins to cough. After a minute or so, it becomes apparent that she is in real distress.

One of the hillbillies looks at her and says, 'Kin ya swallar?'

The woman shakes her head no. Then he asks, 'Kin ya breathe?'

The woman begins to turn blue and shakes her head no.

The hillbilly walks over to the woman, lifts up her dress, yanks down her drawers and quickly gives her right butt cheek a lick with his tongue.

The woman is so shocked that she has a violent spasm and the obstruction flies out of her mouth. As she begins to breathe again, the Hillbilly walks slowly back to his table.

His partner says, 'Ya know, I'd heerd of that there 'Hind Lick Maneuver' but I ain't niver seed nobody do it!'

I was watching a movie recently, Groundhog Day, and there was a scene where Bill Murray goes to a restaurant and someone is choking and he performs the Heimlich Maneuver, and out pops the food that was blocking the person's airway and the person quickly recovers.

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Choking can happen at any time. Choking prevents breathing, and can be partial or complete, with partial choking allowing some, although inadequate, flow of air into the lungs. Prolonged or complete choking results in asphyxia which leads to anoxia and is potentially fatal. Oxygen stored in the blood and lungs keep the victim alive for several minutes after breathing is stopped completely.  One of the most common causes of choking is a foreign object blocking the airway, such as food or small toys.

If you see a person start to choke, they will typically use the universal sign of choking, which is the hands across the throat.  If a person is coughing forcefully, there is no need to take any action.  Encourage coughing, or even slapping them on the back.  Sometimes when I drink water it will go "down the wrong way" and my mother will tell me to raise my arms.  This has never helped me, but it may help you.  Keep watching closely, and if they stop coughing, that is the time to go into action.  Ask if they are ok...then follow these steps:

1. From behind, wrap your arms around the victim's waist.
2. Make a fist and place the thumb side of your fist against the victim's upper abdomen, below the ribcage and above the navel.
3. Grasp your fist with your other hand and press into their upper abdomen with a quick upward thrust. Do not squeeze the ribcage; confine the force of the thrust to your hands.
4. Repeat until object is expelled.

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If choking occurs with a small child or infant, there are other procedures to take to prevent causing injury to them.  With a baby you will want to place them on your lap so that their head is lower than their body, have them on their stomach, so that you will be able to slap their backs.  This is the proper technique, however, in most actual cases the rescuer will become excited, and hang the child upside down and shake.  Caution must be taken to prevent injury to the child.

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If you find yourself alone and become choked, a person may also perform abdominal thrusts on themselves by using a fixed object such as a railing or the back of a chair to apply pressure where a rescuer's hands would normally do so. As with other forms of the procedure, it is possible that internal injuries may result.

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Taking time to chew your food properly or keeping small objects away from children is the key for prevention of choking.  Taking small bites and proper chewing will help what you swallow to go down efficiently.  Make sure to review the Heimlich Maneuver, and ask those around you if they know the procedure.  It’s never too later to learn, and you could save a life.