CHOKING

By Nurse Diane

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.

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 are 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:

From behind, wrap your arms around the victim's waist.

Make a fist and place the thumb side of your fist against the victim's upper abdomen, below the ribcage and above the navel.

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.

Repeat until object is expelled.

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.

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.

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.

[Photos from Google) 

Choking

(Google Image) 

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.

(Google Image) 

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.

(Google Image) 

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.

Add caption

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.

(Google Image) 

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.

Balloon Warning

When parents thing about toy safety and young children, they mostly think about choking hazards from balls, marbles, and small toy parts.

Surprisingly, balloons cause more choking deaths than balls, marbles, or toy parts.

In addition to choking or aspirating on broken balloon pieces, some children suck in uninflated balloons while trying to blow them up. http://www.cpsc.gov/cpscpub/pubs/5087.html

Part of the reason that so many children choke on balloons may be that parents underestimate the choking hazard from balloons, especially to older children. Although most toys with small parts are labeled as being a choking hazard to children under age 3 if they have small parts, it is important to remember the warning label that should be present on balloon packages:

CHOKING HAZARD - Children under 8 years can choke or suffocate on un-inflated or broken balloons. 

Adult supervision required. Keep un-inflated balloons from children. Discard broken balloons at once.

Balloons

• Balloons are not intended for children under 3 years old. Balloons that have not been inflated can cause suffocation if swallowed.
• Never attach balloons to a crib or a child's bed. Balloons with ribbons can cause strangulation of children under 3 years old.
• Children should never inflate helium balloons without adult supervision
• Always weight balloons and comply with applicable state and federal laws.

Choking

Choking occurs when a foreign object becomes lodged in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, administer first aid as quickly as possible.

The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:

• Inability to talk
• Difficulty breathing or noisy breathing
• Inability to cough forcefully
• Skin, lips and nails turning blue or dusky
• Loss of consciousness
• 
  

If choking is occurring, the Red Cross recommends a "five-and-five" approach to delivering first aid:

Give 5 back blows. First, deliver five back blows between the person's shoulder blades with the heel of your hand.

Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).

Alternate between 5 blows and 5 thrusts until the blockage is dislodged.

To perform abdominal thrusts (Heimlich maneuver) on someone else:

• Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
• Make a fist with one hand. Position it slightly above the person's navel.
• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
• Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.
• If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.
• If the person becomes unconscious, perform standard CPR with chest compressions.

To perform abdominal thrusts (Heimlich maneuver) on yourself:

• If you're alone and choking, you'll be unable to effectively deliver back blows to yourself. However, you can still perform abdominal thrusts to dislodge the item.
• Place a fist slightly above your navel.
• Grasp your fist with the other hand and bend over a hard surface — a counter-top or chair will do.
• Shove your fist inward and upward.

Clearing the airway of a pregnant woman or obese person:

• Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.
• Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.
• Repeat until the food or other blockage is dislodged or the person becomes unconscious.

Clearing the airway of an unconscious person:

• Lower the person on his or her back onto the floor.
• Clear the airway. If there's a visible blockage at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.
• Begin cardiopulmonary resuscitation (CPR) if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.

Clearing the airway of a choking infant younger than age 1:

• Assume a seated position and hold the infant face down on your forearm, which is resting on your thigh.
• Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object.
• Hold the infant face up on your forearm with the head lower than the trunk if the above doesn't work. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions.
• Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency medical help.
• Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.

If the child is older than age 1, give abdominal thrusts only.

To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course