Choking: Causes and Management

Choking is the result of obstruction to the airway. This can be caused by physical strangulation by another person, trauma to the throat – through an accident – or inflammation that closes the airway. More commonly though, choking is caused by food or an object that is lodged in the throat and blocks the windpipe.

MANAGEMENT:

First Aid in Choking with small children and babies:

1. If the infant has difficulty in breathing and is becoming blue, shout for help. Lay him in a head-down position on your forearm. Let your arm rest on your tilted thigh with their head just below your knee. Then give 4 rapid blows to the back with the heel of your other hand between the shoulder blades. It may be inconvenient to rest an older infant on the arm. Lay them face down on your lap, with their head towards the ground and supported with one hand.

2. If you find no improvement, put them on the floor on their back. Using 2 or 3 fingers, give 4 rapid chest thrusts over the breastbone lying in the centre of the chest.
3. If you can now see the foreign object or food in the child’s mouth and feel confident that you can easily remove it, pluck it out with your finger.
4. If the child is not breathing, follow step 3 with mouth-to-mouth 
5. Keep repeating steps 1 to 4 until the child improves, or you get some medical help.

Helping an older child with Choking

St John Ambulance recommend the following phrase to help you remember – Cough it out, Slap it out, Squeeze it out!

1. Encourage your child to cough out the object
2. If this fails slap your child’s back hard until the object is expelled
3. If this fails squeeze your child’s abdomen and follow the instructions below:-

• Stand behind the child and wrap your arms around his waist. Make a fist with one hand and grasp it with the other hand.
• Put your fisted hand on the upper abdomen just below the breastbone of his chest.
• Then press into his abdomen with a sudden springy upward jerk.
• You may have to do this repeatedly (up to a dozen times) for him to bring up the foreign object.

In all cases, mouth-to-mouth breathing may be required if the child is not breathing.

Call for medical help if you have any fears about your child choking.