What is Choking?
Choking is a common phenomenon that almost everyone deals with some time or the other. Choking occurs when a foreign object, usually food in adults or some small toy in infants, gets stuck in the throat and obstructs the passage of air(1, 2). This results in the individual coughing forcefully and having trouble breathing(1). Since choking cuts off all supply of blood to the brain, it is mandatory to give first aid immediately for an individual who is choking.
How To Identify If Someone Is Choking?
The question is how one could tell if an individual is choking or not. An individual with a bout of choking will find it difficult to speak or breathe(2). The hands of the person choking will be at their throat(2). Even if the individual is able to breathe, there will be an audible sound when doing so(2). There will also be constant coughing as the body tries to get rid of the foreign object(2).
Why First Aid is Important in Choking?
If immediate first aid is not given to a person who is choking, then the lips and nails start to become cyanotic and the skin of the patient looks flushed(2). Ultimately, the individual who is choking will lose consciousness. Choking at times goes away on its own if a small object gets stuck; however, if a large object like a chicken bone gets stuck in the throat then immediate first aid is required for choking(2). This article gives an overview of some of the first aid measures that can be given to an individual who is choking.
First Aid for Choking in Adults:
If the individual suffering from choking is able to cough, then he should be allowed to do so until the object causing the choking clears away. In case if the individual is not able to cough, speak or breathe then the following should be done as a first aid for choking:
Back Blows(2): This is the best way to free up the obstructed space causing choking. Just stand behind the individual who is choking and ask the individual to bend at the waist. Now place one arm on the chest and make a fist with the other arm. Now, give at least four to five blows on the upper back around the shoulder blade of the individual. The stuck object will get freed and the choking episode will subside.
Abdominal Thrust(2): This is also quite an effective method to free up the stuck object in the throat and is quite simple to do for relieving choking. All you need to do is hold the individual from behind and place the hands on the abdomen. Now try and lift the individual with the hands pushing the abdomen inwards and upwards. Continue this for at least 10 thrusts. This will put pressure on the object causing choking from down and allow it to get free. These two methods can be adopted alternatively as a first aid for choking until there is complete clearance of the blockage.
CPR: In case if the individual loses consciousness due to choking then immediate CPR should be given and the individual should be taken to the nearest emergency room.
First Aid for Choking in Pregnant Females:
Abdominal Thrust is again the recommended method for clearing the blockage although in cases of pregnant females, the hands should be positioned just beneath the breastbone instead of the abdomen(2). Now give thrusts as if trying to lift the patient. Continue this process until the choking resolves.
First Aid for Choking in an Unconscious Individual:
It is difficult to perform the usual thrusts in unconscious individuals. In such instances the standard procedure to follow for choking is:
- Lie the individual down on the floor or bed with the arms at their side(2).
- If the blockage can be visualized high in the throat, then it can be removed by the fingers. It should be noted here that fingers should only be used if the object can be seen clearly. Also, care should be taken while using fingers to not push the foreign object that is the cause of choking more deep into the throat, as it can worsen the condition(2).
- Start CPR if there is no response from the patient even after removing the object or if the object responsible for choking is not visualized. The chest compressions done during CPR may help clear the object from the throat(2).
First Aid for Choking in Infants and Newborns:
Place the baby gently on the thighs with the back facing upwards(3). Support the baby’s neck and head with the arms. Now bend the baby slightly and thumb the middle of the back gently with the hands. This will dislodge the object causing choking in the baby.
Alternatively, you can place the baby on your thigh with the face towards you. Use two fingers and give gentle chest compressions just below the breastbone(3). This will be good enough to get rid of any object lodged in the throat of the baby. In case the baby is not able to breathe despite the throat being cleared, then start giving CPR and take the baby to the nearest emergency room.