First Aid management of

chocked casualty

By: Mr. Godwin Onesmo

BSN- RN|TA
onesmoyoyo@gmail.com
Dpt: Clinical nursing
UDOM
 Learning objectives
By the end of this sessions, each student should
be able to:-
Define chocking
Identify signs of chocking
Demonstrate first aid management to chocked
client.
 Choking
• Choking occurs when the airway is partially or
completely blocked by a foreign body, such as
a piece of food or an object (a magnet or small
toy).
• Choking is also referred to as a foreign body
airway obstruction
• It is common cause of breathing emergencies,
especially in young children.
 …
• The technique used to help someone who is
choking depends on the person’s age, size and
level of responsiveness.
 People at risk
• Be aware that people who have reduced
responsiveness, a neurological impairment
that affects their swallowing and coughing
reflexes (e.g., Stroke, Parkinson’s disease,
cerebral palsy or dementia) or
• People are also at a higher risk if they are
intoxicated (due to drugs or alcohol).
 Signs of choking
Mild choking
 Weak or forceful coughing.
 Can speak or cry out.
 Makes high-pitched noises while inhaling, but
is still able to breathe.
 ….
Severe choking
 Unable to cough, speak, cry or breathe
 Clutches the throat with one or both hands
 Panic
 Bluish colour to the skin of the lips, ears,
fingers and toes
 Becomes unresponsive if the blockage is not
removed
 Techniques on management of choking

Back blow
Abdominal thrust
Chest thrust
Finger sweep
 First aid management
Adults and children
Mild choking
1. Encourage the person to cough to clear the
blockage.
2. Monitor the person until they improve, as it
could develop into a complete airway
obstruction.
 Management……….
Severe choking
1. If the person cannot cough, speak or breathe, give up
to five firm blows between their shoulder blades.
2. If the back blows are unsuccessful, give up to five
abdominal thrusts by putting your fist between their
ribs and their belly button and pulling it sharply
inward and upward using the other hand.
3. If the abdominal thrusts are unsuccessful,
immediately access emergency medical services
(EMS).
4. Continue alternating between five back blows and
five abdominal thrusts until the blockage clears or
the person becomes unresponsive
Make a fist. Place the fist below the xiphoid
process, above the client’s navel
 Performing the Heimlich Maneuver

• Refer:
Sue C. DeLaune & Patricia K. Ladner (2011)
Fundamentals of Nursing Standards & Practice
4th Edition.
• Page no: 902
 Why back blow and abdominal thrust
 Back blows create a strong vibration and
pressure in the airway
 Abdominal thrusts and chest thrusts squeeze
the air out of the lungs, creating additional
pressure in the airway.
These techniques may dislodge the object and
help the person to breathe again.
 Infants
Mild choking
1. If the baby is coughing, wait to see if they can
cough to clear their own airway.
2. Monitor the baby until they improve, as it
could develop into a complete airway
obstruction.
 Severe choking
1. If the baby cannot cough or breathe, give up to
five firm blows between their shoulder blades.
2. If the back blows are unsuccessful, turn the baby
over and give up to five chest thrusts by pushing
sharply downwards in the centre of their chest.
3. If the chest thrusts are unsuccessful, access EMS
immediately.
4. Continue alternating between five back blows
and five chest thrusts until the blockage clears or
the baby becomes unresponsive.
Emergency care for an infant who is choking consists of a series
of five blows to the back between the shoulder blades, followed
by five thrusts midline on the chest approximately 1 inch below
the nipple line.
Practising back blows and chest thrusts
for a choking infant you should sit or
kneel.
 Why no abdominal thrust to infants
 Not use abdominal thrusts for infants since
their organs are still developing and may get
damaged.
Alternatively its replaced by chest thrust

 Use of gravity (by bending over or holding the

infants head lower than the body) can help
dislodge the foreign object or liquids drain
out.
 Guidelines
Immediately after recognition, can carry out
interventions to support the removal of a
foreign body airway obstruction.
Back blows may be used initially on people
with a foreign body airway obstruction and an
ineffective cough.
Abdominal thrusts may be used on adults and
children with a foreign body airway
obstruction and an ineffective cough where
back blows are ineffective.
 Guidelines….
First aid providers may consider the manual
extraction of visible items in the mouth.
First aid providers should not use blind finger sweeps
on a person with a foreign body airway obstruction,
as this may push the object further down the
person’s airway.
First aid providers should use standard CPR,
consisting of both chest compressions and rescue
breaths if possible, on an unresponsive person with a
foreign body airway obstruction
Misconceptions
 Misconceptions
• Giving the person a drink to clear airway
blockage and??
• Hanging a baby upside down.??
 Start CPR
• If someone who is choking becomes
unresponsive it is necessary to start CPR
 Practice points
 When helping a responsive person, first aid
providers must be able to recognize the signs
of partial airway obstruction (the person can
speak, cough and breathe) and complete
airway obstruction (the person is unable to
speak, has a weakened cough and has
difficulty breathing).
 A person with partial airway obstruction
should be monitored until they improve, as it
could develop into a complete airway
obstruction.
 Practice points…
 Responsive babies may receive a combination
of back blows followed by chest thrusts to
clear the obstruction from the airway.
 Back blows and abdominal thrusts or chest
thrusts should be applied in quick succession
until the obstruction has been cleared from
the airway.
 Practice points…
 In responsive adults and children who are
choking, chest thrusts, back blows or
abdominal thrusts are equally effective.
 An unresponsive baby should receive a
combination of rescue breaths and chest
compressions to clear the obstruction from
the airway.
Practice, practice, practise!