Basic First Aid: Choking in Infants – (Part 4)

There are different ways to deal with choking, depending on how severe the choking episode is, as we have seen in the previous two articles. Additionally, dealing with choking babies and infants under one year of age involves different but similar techniques.

As in any case, you start off by assessing the situation. Obviously, it’s unlikely that a baby will make the universal choking sign (clutching throat with hands), so one has to look out for other signs.

If the baby is coughing or making noises, such as gagging, or has a strong cry, this indicates that the airway is only partially blocked, and so allowing coughing to continue might clear the airway of the blockage. Keep monitoring the baby for worsening signs.

More severe choking indicates complete airway obstruction, and this may be observed by lack of noises made by the baby, such as lack of coughing (or weak and ineffective coughing), breathing or crying. Furthermore, the baby may appear distressed, bluish skin, and having difficulty breathing. In this case, you should turn the baby lying face-down along the length of your forearm, supporting him/her well. The baby should be held with the head low, to enable the obstruction to clear. Using the heel of your hand, give up to 5 blows to the back. The blows should strike the area between the shoulder blades, and should be firm.

The infant’s mouth should then be checked for any obvious obstruction. It is important not to attempt to remove any obstruction which is not obvious, as this might push the obstruction further into the mouth.

If back blows don’t help shift the obstruction, chest thrusts are required. These are not the abdominal thrusts we discussed in the previous article, as a different manoeuvre needs to be employed.

Turn the baby on its back. Use 2 fingers and push inwards and upwards against the breastbone, towards the head. The fingers should be placed one finger’s breadth below the nipple line. Check after each thrust whether the obstruction has been displaced, and if visible, attempt to remove it.

Again, do not attempt to sweep the mouth with your finger in a bid to find and remove the obstruction.

If after 3 cycles of back blows and chest thrusts the baby’s airway is still obstructed, phone an ambulance, and continue with the cycles until help arrives. Only perform these steps if the baby stops breathing due to an obstructing object.

These articles are not a substitute for formal education in first aid. I encourage all readers to sign up for a course today! There are many companies that provide such a service, and it really doesn’t take long to become certified. Who knows? You could save someone’s life one day.

References:

www.sja.org.uk www.nhs.uk/chq raisingchildren.net.au