How Should You Handle A Conscious Choking Casualty?

              

How Should You Handle A Conscious Choking Casualty?

When a person is choking, it is crucial to react promptly and with confidence to help them regain the ability to breathe. Choking occurs when an object, typically food or a foreign item, obstructs the airway. The severity of the choking can be classified as either mild or severe, and your response will depend on the extent of the obstruction.

In cases of mild choking, the individual may be able to cough effectively, make noise, or breathe. In this situation, it's best to encourage them to continue coughing to expel the object. However, you should closely monitor their condition and be ready to intervene if it escalates.

Severe choking, on the other hand, is characterised by the inability to speak, breathless gasping, or a complete lack of sound. If this occurs, immediate action is necessary. You should call for emergency medical help right away and prepare to perform the Heimlich manoeuvre (abdominal thrusts) to dislodge the obstruction. Remember to remain calm, as this reassures the person in distress and helps you to act effectively. The ability to recognise the seriousness of the situation and respond accordingly can make all the difference in saving a life. Here are some tips and advice:

Assess the Situation

• Mild Choking: If they can talk, cough, or breathe, they have a mild choke. Encourage them to keep coughing, as this can help dislodge whatever is blocking their airway. Stay nearby and watch for any changes in their condition.
• Severe Choking: If they cannot speak, breathe, or cough, they are severely choking, and you need to act right away.

Take Action (Severe Choking)

If the person is unable to breathe or cough, follow these steps immediately:

• Call for Help: If there are other people around, ask one of them to call emergency services. If you're alone, call for help right away. It’s best to use speakerphone so you can still help the person while talking to emergency responders.
• Give 5 Back Blows:
  - Stand to the side and just behind the person.
  - Support their chest with one hand to keep them steady. Lean them forward so that anything that gets dislodged will fall out of their mouth.
  - Use the heel of your other hand to give up to 5 quick and firm hits between their shoulder blades. Make sure these hits are strong enough to potentially push the blockage out.
• Perform 5 Abdominal Thrusts (Heimlich Manoeuvre):
  - If the back blows don’t work, move behind the person.
  - Put your arms around their waist to keep them steady.
  - Make a fist with one hand and place it just above their belly button. Make sure it’s below the ribcage to avoid injury.
  - Grab your fist with the other hand and push inward and slightly upward. Do this movement up to 5 times.
• Repeat: Alternate 5 back blows and 5 abdominal thrusts until the obstruction is gone or help arrives.

Special Considerations

• Pregnant or Larger People: Chest thrusts are an important method for helping someone who is choking, especially when the usual method of abdominal thrusts (or Heimlich manoeuvre) isn’t safe or effective, such as for pregnant individuals or those with obesity. 
• Here’s a simple guide on how to perform chest thrusts:
  -    Get Positioned: Stand behind the person who is choking. Wrap your arms around their chest, just below the armpits. This will help you provide support and stability as you help them.
  -    Place Your Hands: Make a fist with one hand and place the thumb side against the lower half of the person’s breastbone (the flat bone in the middle of their chest). Be careful not to touch their ribs, as this is important for performing the thrusts safely.
  -    Give the Thrusts: With your other hand, hold your fist in place and push inward and slightly upward in a quick, strong motion. This helps generate the pressure needed to dislodge whatever is blocking their airway.
  -    Repeat if Needed: If the first thrust doesn’t work, continue to perform up to five thrusts. Keep an eye on the person to see if their airway clears. If they can breathe again, great! If not, continue the thrusts until medical help arrives or the blockage clears.
• If They Pass Out: If the person becomes unconscious, carefully lay them down to prevent injury. Call emergency services immediately if you haven’t done so already. Once they’re on the ground, start CPR, beginning with chest compressions. Continue CPR until help arrives or the person shows signs of recovery.
• For Children (Over 1 Year): Use the same methods as for adults, but apply less force since they are smaller.
• For Infants (Under 1 Year): Do not do abdominal thrusts. Instead, lay the baby face down on your forearm, supporting their head, and give 5 firm back blows. If that doesn’t work, turn the baby over and provide 5 chest thrusts using two fingers in the centre of their chest.

What NOT To Do

- Don’t stick your fingers in their mouth to try to remove the blockage unless you can clearly see it. This can push it deeper.
- Don’t hit a choking person on the back while they’re standing, as this may make things worse.
- Never leave the person alone while you wait for help.