Instructions for first aid treatment of choking

Articles written by MSc, BS. Le Thi Thanh Huong, Emergency Department - Vinmec Central Park International General Hospital

Choking is a condition in which food or foreign objects get caught in the throat and cause airway obstruction, preventing air from entering the lungs. This is a very common emergency, especially in children and infants (eg: choking on milk, choking on toys or food, or falling into the airways). The content of the article helps guide the steps for a normal person to recognize and give first aid to a choking victim.

Choking can happen at any age, and has many degrees:
1.1. Mild level 1.1.1. Signs Victim is choking but still able to:
Speak or make a sound Coughing loudly. 1.2.2. Management Stay with the choking person and encourage the person to continue coughing. If you are not sure about the victim's breathing problems, you should call 911. Continue to stay with the casualty until the ambulance arrives. 1.2. Choking severity 1.2.1. Identify Victim in a suspected choking situation, and:
Unable to breathe, unable to speak or unable to make a sound; Cough but no sound; Choking sign: The victim uses one or both hands to hold the neck.

1.2.2. Action When the victim shows signs of severe choking, immediate intervention is required:
If you think the victim is choking, ask immediately “Are you choking? Can I help you?” If the victim nods in agreement, you need to intervene immediately. Stand or kneel behind the casualty (depending on the victim's size), possibly stepping one leg forward for more stability. Wrap your arms around, holding both hands in front of the victim. A clenched fist forms a fist. Place the thumb side of the fist between the position above the navel and below the breastbone. With the other hand grasping the fist, thrust quickly and forcefully into the victim's abdomen backward and upward. Continue to give multiple compressions until the object is ejected and the victim is able to breathe, cough, or talk, or the victim becomes unresponsive.

Note: If the victim is a pregnant woman, or someone with a large belly, you can't hug around the waist, need:
Wrap your arms around the victim's armpit, place your fist on the lower half of the breastbone area of ​​the chest . When pushing, squeeze your fist into your chest straight back.

Choking, especially choking on milk, is one of the common emergencies in infants.
For infants who are choking, squeezing the abdomen can make the situation worse. You just conduct the back patting and chest compressions test according to the following steps:
Place the baby on his/her stomach on the forearm, the hand supporting the head and the lower jaw. The head is placed lower than the body. Use the mound of your other hand to pat the baby's back 5 times, between the baby's shoulder blades. After 5 pats on the back, but the foreign body still hasn't come out, turn the baby upside down, hand supporting the baby's head. Use two fingers to give chest compressions 5 times at a position above the sternum across the line between the nipples (similar to the position of chest compressions in CPR - Cardiac arrest) (see also how to rescue cardiac arrest for children and infants in Lesson BLS – Basic Cardiopulmonary Resuscitation Manual). Repeat 5 back pats and 5 chest compressions until baby can breathe again, cough or cry, or until baby is unresponsive.

3.1. First Aid to a Choking Victim Who Has Been Unresponsive in Adults If you cannot remove the object and the victim begins to lose response (calling unconscious) and stops breathing or yawns, CPR should be performed. immediately (see how to give first aid to an adult cardiac arrest in Lesson BLS - Basic CPR Guide) follow these steps:
Call people around to assist in getting an AED – an automatic shock machine (if the area is not in the area). equipped emergency area). Call 911 (115 or the nearest emergency number). Turn on the phone, turn on the speakerphone mode so that you can receive instructions from emergency personnel. Perform CPR, starting with chest compressions. Heart rate 30 beats. Then open the victim's mouth to look inside, if you see a foreign object in the mouth, then pull it out (if you can't see the foreign body, don't go blind). Give 2 breaths, and then continue chest compressions for 30 beats. Continue CPR and check for foreign bodies before breathing until: Victim is moving, talking, blinking, or any other response. Or have professional emergency personnel come and take the victim away. 3.2. First aid for choking victims who have lost their response in children and infants Call people around to help get an AED – an automatic shock machine (if equipped in the emergency area). Place your baby on a hard surface. Start CPR – CPR (see CPR for children and infants in Lesson BLS – Basic CPR) and call 911 on speakerphone outside. Note:
If someone else comes to help, have the facilitator call 911 or the nearest emergency facility, then go get the AED while you're still doing CPR. If no one comes to help, but you have a phone with you: Call the emergency department, turn on speakerphone to contact while CPR is still in progress. Perform 5 cycles of 30 beats of chest compressions and 2 breaths of respiration. Then leave the baby and run to get the AED. Quickly return to resume CPR on your baby. If no one comes to help and there is no cell phone at hand, perform 5 cycles of 30 beats of chest compressions and 2 beats of ventilation. Then run to find the phone to call the emergency unit and get the AED. Quickly return to resume CPR on your baby. If the baby is young and has no other associated injuries, after 5 cycles of 30 compressions: 2 ventilation, you can take your baby with you to the phone call and get the AED. Conduct CPR for a baby choking according to the following steps: Give 30 beats of heart pressure Then open the victim's mouth to look inside, if you see a foreign object in the mouth, then pull it out (if you can't see the foreign body, don't blind it). Provides 2 breaths. Continue CPR and check for foreign bodies before breathing until: Victim is moving, talking, blinking, or any other response. Or have professional paramedics arrive. As soon as the emergency choking on the spot, take the patient to a medical facility immediately. Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
A system of modern and advanced medical equipment, possessing many of the best machines in the world, helping to detect many difficult and dangerous diseases in a short time, supporting the diagnosis and treatment of doctors the most effective. The hospital space is designed according to 5-star hotel standards, giving patients comfort, friendliness and peace of mind.