26/05/2012

Sequence for the treatment of adult choking


(This sequence is also suitable for use in children over the age of 1 year)
1. If the victim shows signs of mild airway obstruction:
 Encourage him to continue coughing, but do nothing else.
2. If the victim shows signs of severe airway obstruction and is conscious:
 Give up to five back blows.
o Stand to the side and slightly behind the victim.
o Support the chest with one hand and lean the victim well forwards
so that when the obstructing object is dislodged it comes out of
the mouth rather than goes further down the airway.
o Give up to five sharp blows between the shoulder blades with the
heel of your other hand.
Check to see if each back blow has relieved the airway obstruction. The aim
is to relieve the obstruction with each blow rather than necessarily to give all
five.
 If five back blows fail to relieve the airway obstruction give up to five
abdominal thrusts.
o Stand behind the victim and put both arms round the upper part of
his abdomen.
o Lean the victim forwards.
o Clench your fist and place it between the umbilicus (navel) and the
bottom end of the sternum (breastbone).
o Grasp this hand with your other hand and pull sharply inwards and
upwards.
o Repeat up to five times.
 If the obstruction is still not relieved, continue alternating five back blows with
five abdominal thrusts.
3. If the victim becomes unconscious:
 Support the victim carefully to the ground.
 Call an ambulance immediately.
 Begin CPR (from 5B of the adult BLS sequence). Healthcare providers, trained and experienced in feeling for a carotid pulse, should initiate chest compressions even if a pulse is present in the unconscious choking victim. Following successful treatment for choking, foreign material may nevertheless remain in the upper or lower respiratory tract and cause complications later. Victims with a persistent cough, difficulty swallowing, or with the sensation of an object being still stuck in the throat should therefore be referred for an immediate medical opinion.

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