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Choking

If you are working with infants and children, ensure that you keep marbles, beads, thumbtacks, and other small objects out oftheir reach and prevent them from walking, running, or playing with food or toys in their mouths.

If you observe a "conscious" child choking:

  • -Ask, "Are you choking?"
  • -If the victim can speak, cough, or breathe, DO NOT INTERFERE.
  • -If the victim CANNOT speak, cough, or breathe, give subdiaphragmatic abdominal thrusts (the Heimlich maneuver) untilthe foreign body is expelled or the victim becomes unconscious. (Or in case of extreme obesity or late pregnancy, give chest thrusts.)

The Heimlich Maneuver for CHOKING

A choking victim can't speak or breathe and needs your help immediately. Follow these steps to help a choking victim:

  • 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; confinethe force of the thrust to your hands.
  • Repeat until object is expelled.

UNCONSCIOUS VICTIM, OR WHEN RESCUER CAN'T REACH AROUND VICTIM:

  • Place the victim on back. Facing the victim, kneel astride the victim's hips. With one of your hands on top of the other, place the heelof your bottom hand on the upper abdomen below the rib cage and above the navel. Use your body weight to press into the victim's upper abdomenwith a quick upward thrust. Repeat until object is expelled. If the Victim has not recovered, proceed with CPR.
  • The Victim should see a physician immediately after rescue.
  • Don't slap the victim's back. (This could make matters worse.)

The Heimlich Maneuver for CHOKING INFANTS

A choking victim can't speak or breathe and needs your help immediately.

Follow these steps to help a choking infant:

An infant or child can choke on food or toys that are small enough to enter the windpipe. If your child has swallowed somethingbut can breathe and is able to cough or speak, it is best not to interfere because he or she will likely cough it out. If your child cannot breathe,cough or speak, take immediate action. Call 911 for help and then start treatment. The method of treatment varies with the child's age:

For an infant (younger than 1 year):

  • Place the baby's face down on your lap with the head lower than the body.
  • With the heel of your hand, hit your baby high between the shoulder blades four times.
  • If the object does not come out, turn your baby over and compress (push on) the chest over the breast bone four times.
  • If your child is still not breathing, open the mouth to see if you can remove the object with your finger.
  • Try mouth-to-mouth breathing, and keep repeating this whole process until help arrives.
  • For an older, larger child (older than 1 year), use the Heimlich maneuver to try and remove a foreign object:
  • Put the child on his back on the floor or a table.
  • Place the heel of one hand between his belly button and the breast bone in the middle of his abdomen. Put your other hand on top of the first handand press inward and upward six to 10 times in rapid succession.
  • Check the child's mouth quickly for the object, and try to remove it if it is visible.
  • Try mouth-to-mouth breathing and then repeat the Heimlich maneuver. Keep trying until help arrives.
  • The Heimlich maneuver can be done on a very large child in the standing or sitting position (from behind).

If the Victim Becomes Unconscious:

-Position victim on back, arms by side.

-Call out "Help!", or if others respond, call 911.

-Perform tongue-jaw lift and finger sweep to try to remove the foreign body.

-Open airway (head-tilt/chin-lift), and attempt rescue breathing.

-If unsuccessful, give 6-10 subdiaphragmatic abdominal thrusts (the Heimlich maneuver).

-Repeat sequence: perform finger sweep, open the airway, attempt rescue breathing, perform abdominal thrusts -- untilsuccessful.

-After obstruction is removed, begin the ABC's of CPR if necessary.

-BE PERSISTENT. Continue uninterrupted until obstruction is relieved or advanced life support is available. Whensuccessful, have the victim examined by a physician as soon as possible.

Teeth knocked out

Treatment: If your child's baby tooth has been knocked out because of an accident, leave the tooth out. Baby teeth are not put backinto place (reimplanted) because it may damage the permanent tooth that is forming.

If your child's permanent tooth is knocked out, quick action is needed to give the tooth its best chance of successfully beingreimplanted. Here are the steps needed:

  • Look for the tooth and pick it up by its crown (the white part), not the root.
  • Carefully rinse the tooth with water. Remember to put the stopper into the sink! Do not scrub the root or you may remove important tissuethat will be needed for the tooth to reconnect to the bone and gums.
  • If possible, place the tooth into its socket. If that is not possible, keep the tooth moist in a glass of milk or water.
  • Transport your child and the tooth to your dentist immediately. Your dentist will reimplant the tooth and put on a splint to anchor it inplace. Teeth have the best chance of reattaching if they are reimplanted within an hour of being knocked out.

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Source:  OpenStax, Health education course. OpenStax CNX. Feb 03, 2006 Download for free at http://cnx.org/content/col10330/1.1
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