4Airway EmergenciesThe airway is the passage through which the air moves from the nose and mouth to the lungs.If anything blocks the airway, the person chokes and cannot get enough oxygen, and life is threatened.This is an emergency, and you must give first aid to clear the airway.
6Causes of Airway Obstruction An airway obstruction can occur if the tongue or swollen tissues of the mouth block the airway caused by:1. An injury to the mouth2. A severe allergic reaction3. The tongue dropping to the back of the throat and blocked the airway
7Causes of ChokingAny airway blockage caused by a foreign object or fluid is called choking.
8Causes of Choking 1. Trying to swallow large pieces of food. 2. Excess alcohol, causing suppression of the gag reflex, and then choking on food.3. Wearing dentures4. Eating with talking excitedly or laughing or eating too quickly5. Walking, playing or with food, small toys or other objects in the mouth
9Signs and Symptoms of Choking A person who is choking may have a partial or complete blockage of the airway.A complete blockage will not allow breathing.A partial blockage may be cleared by the person coughing.
10Signs and Symptoms of Partial Obstruction 1. High pitched or wheezing sounds when breathing in2. Coughing3. Clutching at the throat with one or both hands
11Signs and Symptoms of Complete Obstruction 1. May be conscious or unconscious2. Unable to breathe3. Unable to speak4. Unable to cough5. Face may appear bluish
12Signs and Symptoms of Complete Obstruction A conscious adult can usually indicate they are choking.With an infant or small child who is conscious but not able to breathe assume they are choking on something.
13First Aid for ChokingFor a patient with partial airway obstruction do not interfere with their attempts to cough up the object.If the patient is no longer able to cough or speak, treat as for complete obstruction.
14First Aid for a Conscious Choking Adult with Complete Airway Obstruction 1. Ask “Are you choking?”2. Summon someone to help you.3. Attempt abdominal thrusts - stand behind the person and wrap your arms around their waist.4. Make a fist with one hand and place the thumb side of the fist on the middle of the abdomen slightly above the navel.
15First Aid for a Conscious Choking Adult with Complete Airway Obstruction 5. Grasp your fist with the other hand and give quick upward thrusts into the abdomen to dislodge the object.6. Repeat until the choking stops or they become unconscious
16Abdominal Thrusts for a Conscious Choking Adult with Complete Airway Obstruction Use chest thrusts when you can’t reach far enough around the patient, or for women in late pregnancy1. Place your arms under the patients armpits and around the chest.2. Make a fist with one hand, place the thumb side against the centre of the patient’s breastbone.
17Abdominal Thrusts for a Conscious Choking Adult with Complete Airway Obstruction This is not to be the lower tip of the breast bone and not on the ribs).3. Grab you fist with the other hand and thrust inward.4. Repeat until the object is dislodged or the patient becomes unconscious.
18When to Stop Chest Thrusts, Abdominal Thrusts and Back Blows Stop immediately if the object is dislodged or if the patient begins to breathe or cough.Make sure the object comes out.The thrust can cause internal injuries, and should be seen by EHS.
19First Aid for Conscious Choking Children with Complete Airway Obstruction The significant difference for treating a child over the age of 1, is use less force to expel the objectMake sure you are sitting or stable before startingOtherwise use the same method as an adult
20First Aid for Conscious Choking Infants with Complete Airway Obstruction First determine if the infant is choking by observing if the infant can breathe, cough or cry or is coughing weakly or making high pitched sounds.Do not use abdominal thrusts.
21First Aid for Conscious Choking Infants with Complete Airway Obstruction Turn the infant face down on your fore arm with the head lower than the body, and with the heel of your hand give five forceful back blows between the infant’s shoulder blades.Then turn the infant over, with its head lower than its body.
22First Aid for Conscious Choking Infants with Complete Airway Obstruction Give five chest thrusts using your middle and index fingers on the breast bone one finger width below the nipple line.Repeat back blows and chest thrusts until object is coughed up or infant becomes unconscious.
23First Aid for Conscious Choking Adult Who Becomes Unconscious If the obstruction cannot be removed the casualty may become unconscious.1. Lower the casualty to the floor on their back.2. Open the airway and look for an obstruction.3. If seen, lift the lower jaw, remove the object by sweeping it out using a hooking action with your finger.4. Be careful not to push the object deeper
24First Aid for Conscious Choking Adult Who Becomes Unconscious 5. Next try to open the airway using head tilt/ chin-lift method
25First Aid for Conscious Choking Adult Who Becomes Unconscious 6. Assess for effective breathing for 10 seconds.7. If not breathing attempt to ventilate.8. If air does not go into the lungs, retilt the head and try again.9. If air still does not go into the lungs, assume the airway is still obstructed and begin the CPR sequence with 30 chest compressions.
26First Aid for Conscious Choking Adult Who Becomes Unconscious 10. After those, open the airway and look in the mouth.11. If you see an object, remove it.12. If you cannot get air into the casualty’s lungs continue the CPR sequence, always looking in the mouth before the ventilation attempt. Keep trying to clear the airway.13. If you see and change in the person’s condition, stop CPR and reassess the ABCs.
27First Aid for Conscious Choking Adult Who Becomes Unconscious 14. Once you can breathe air into the casualty’s lungs, give two rescue breaths.15. Then complete the primary survey by checking casualty for signs of circulation and checking and caring for severe bleeding.16. If there are no signs of circulation, begin CPR.
28First Aid for Conscious Choking Adult Who Becomes Unconscious 17. If the casualty has signs of circulation but is not breathing on their own, continue rescue breathing.If the casualty starts breathing on their own, monitor the breathing and circulation, maintain an open airway, and get to EHS.Put the casualty into the recovery position.
29First Aid for an Unconscious Choking Adult 1. Open the airway and place your ear close to the person’s mouth, then look, listen and feel for signs of breathing for 10 seconds.Look at chest and abdomen for movementListen for breathing soundsFeel for exhaled breath on your cheekIf none of these signs are present the casualty is not breathing
30First Aid for an Unconscious Choking Adult 2. Use the head tilt/ chin lift method to open the airway.3. Attempt to ventilate.4. If air does not go into the lungs, re-tilt the head and try again.5. If air still does not go into the lungs, assume the airway is still obstructed and begin the CPR sequence with 30 chest compressions.
31First Aid for an Unconscious Choking Adult 6. After those, open the airway and look in the mouth.7. If you see an object, remove it.8. If you cannot get air into the casualty’s lungs continue the CPR sequence, always looking in the mouth before the ventilation attempt. Keep trying to clear the airway.9. If you see and change in the person’s condition, stop CPR and reassess the ABCs.
32First Aid for an Unconscious Choking Adult 10. Once you can breathe air into the casualty’s lungs, give two rescue breaths.11. Then complete the primary survey by checking casualty for signs of circulation and checking and caring for severe bleeding.12. If there are no signs of circulation, begin CPR.
33First Aid for an Unconscious Choking Child or Infant First aid for a child under 8 is the same as an adult with 30 compressions, but only performed with one hand.First aid for an infant is the same but with two fingers.
34Choking Emergencies Problem Signals Care Casualty conscious Coughing forcefully Encourage casualty topartial obstruction Can speak and breathe continue coughingWheezing If coughing persists, callEHSCasualty conscious Coughing weakly Get helpcomplete obstruction Cannot speak or Begin abdominal thrustsbreathe (back blows and chest thrusts for infants)
35Choking Emergencies Problem Signals Care Casualty unconscious No breathing Call EHScomplete obstruction Breaths won’t go in Begin CPRLook in casualty’s mouthfor an obstruction aftereach cycle ofcompressions beforeattempting to ventilate
36Head Tilt / Chin LiftThis can be used to stop the tongue from blocking the airway.If the airway is blocked by swollen tissue, this may not work.If air goes in from rescue breaths, the airway is clear.