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First Aid for Choking

Updated on October 18, 2015

Accidents happened everywhere even in schools. Teachers and other responsible adults within the school premises should be aware and ready to respond every time this accident happen. Presence of mind and being calm are two things teachers should remember when responding to this kind of accident.

Choking or strangling occurs when a person accidentally draws food into the air passage leading to the lungs or attempt to swallow a piece of food too large to pass through the esophagus. It may occur when a child at play breathes a small object into his larynx.

The person makes a great effort to breathe. He is unable to speak. His head is thrown back, his eyes protrude, and his face becomes bluish red.If air passage becomes completely closed, he soon collapse and die within minutes if does not received help.

Food choking is said to be the sixth most common cause of accidental death. In middle-aged and elderly people, death from choking is easily mistaken for heart attack.

The "classic" victim of food choking is the elderly person who wears dentures, who is eating steak or beef, and who has had an alcoholic drink. The alcohol contributes because it hinders the person in judging the size of the piece of meat he is trying to swallow.

What to do when someone is choking

There are three approved maneuvers for rendering first aid to the choking person. These are (1) Back Blow, (2) Epigastric Thrust, (3) Finger Prove.


1. Back Blows.

This maneuver requires the operator to use the heel of his hand to deliver a series of rapid whacks to the victim's spine between his shoulder blades. This may be done with the victim standing, or lying on his side. The blows should be forceful enough to jar the victim's body and thus hopefully, to dislodge the object the obstructs his air passages. A gentle modification of maneuver may be used in the case of an infant by supporting the infant, face down, on one's forearm. The infant's head should not be lowered below the level of his body, however, if he is still able to breathe, even partially, when in the upright position. Only when he is unable to breathe at all should his head be held low.


2. Epigastric Thrust

There is some air in the lungs even when the person's air passage are closed. The epigastric thrust maneuver is designed to force this residual air out of the lungs so quickly that it pushes the material trapped in the throat upward into the mouth. This is done by making quick pressure upward through the soft tissues of the "epigastrium" - that part of the front portion of the body wall just below the breastbone and between the lower ribs. The pressure forces the diaphragm upward, compressing the lungs, forcing the air upward through the air passages.

The maneuver can be performed with the victim standing, sitting, or lying on the back. When the choking person is standing or sitting, the operator works from behind. He wraps his hands around the victim's waist, placing the thumb side of one fist against the victim's abdomen just above the navel and just below the ribs. He then grasp this fist with his other hand and makes a quick upward thrust. This may be repeated if not successful the first time.

When the victim is lying on his back, this is performed as the operator kneels beside the victim or straddles his hips. He places one hand on top of the other, with the heels of the lower located slightly above the victim's navel and just below the ribs. The operator then rocks forward as he makes quick upward thrust in the midline of the victim's body.


3. Finger Prove

This is especially useful when a lump of food or other firm object id lodged in the victim's throat. Open the victim's mouth widely, grasp the tip of his tongue through the fold of a handkerchief, and pull the tongue lower forward. Pass the forefinger of the other hand over the tongue and along the side (not the middle of the victim's throat far enough to reach the edge of the obstructing object further into the air passages.) Then with the sweeping motion of the finger, bring the object forward into the victim's mouth.

Even though the victim appears to be breathing normally again, he should be seen by a physician to determine whether the obstruction has been completely removed and whether there has been any damage to his tissues by the maneuver used to restore breathing.

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