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So, now let's take a look at the conscious infant choking patient. There's a few things that should tip us off that the baby is fully conscious but also fully choking. That is that their eyes are open, they may be gagging, they're still moving around but they're not breathing. They're not coughing and they're certainly even able to babble or if they're able to speak they're not saying any words. You may even start to see this thing called circumoral cyanosis that's a blue ring that starts to form around the lips of the baby indicating that they're beginning to starve of oxygen and our treatment is really necessary. If you have a bystander nearby it wouldn't be a bad idea, and it would certainly be in the best interest of the baby, if you had them call 911 and get the ambulance on the way. If you didn't have anybody around you could certainly call 911 but I still think it's in the best interest of the baby for you to begin doing the treatment first and waiting until the baby goes unconscious, if it's up to you to have to call 911. So what we're gonna do is to remove this onesie so that I can really show you the landmarks that are important as we begin to demonstrate the skill related to getting this obstruction clear. I'm going to place my thumb and forefinger over the cheekbones of the baby's face. Supporting the head and neck, letting them rest on my forearm while they straddle my bicep. I'm now going to take the opposite palm and use that to give five back blows, or back slaps, between the shoulder blades of the baby. It's important to remember that the head of the baby is down while the feet are higher than the head. That allows gravity to work with us, not against us. Five back blows. One, two, three, four, five. Sandwich the baby's head and neck to support the neck and head. And now we are going to repeat with five chest thrusts One, two, three, four, five.If the baby did not get rid of the obstruction and indicating that with breathing again, coughing, gagging, starting to try to cry we're simply going to repeat the process. We're going to sandwich the thumb and forefinger over the cheekbones, flip the baby back over, face down, straddling our bicep and repeat with five back blows. One, two, three, four, five. Turn the baby over. five more chest thrusts. One, two, three, four, five. We're going to continue to do these back blows and chest thrusts until the object comes out, the baby begins to breathe again, or the baby goes unconscious. If the baby goes unconscious it's at this time, that we, if we haven't done it already, we call 911 and get an ambulance on the way. If the baby does go unconscious we then move into the unconscious infant choking procedure. But, it's important to note that when we're doing the back blows and the chest thrusts make sure we don't let our arms sag with each of those compressions or back blows as when it sinks down it diminishes the effect of the actual chest thrusts that are forcing the air up the trachea to pop that object out. Keep in mind that this is about 80 percent effective when you do the chest thrusts and back blows. It's an extremely effective procedure and it can work really well if you run into this type of situation.
This conscious infant choking lesson is for situations where you can see that an infant is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including:
Signs that the infant is conscious include:
Remember to activate EMS as soon as possible so long as it doesn’t delay care. If possible, have another person nearby call. Otherwise, don't waste time calling 911 and go right into assessing and helping the infant.
Helping a conscious choking infant isn’t significantly different than helping a child or an adult. You'll still be performing a combination of back slaps and thrusts to try and dislodge the airway obstruction. The biggest difference between infants when compared to adults or children, rather than performing abdominal thrusts, for infants we need to make sure we are performing chest thrusts rather than abdominal thrusts.
Warning: Due to the fragile nature of infants performing abdominal thrusts on them could cause severe internal injuries. Chest thrusts should be used for conscious choking infants.
If there is a parent or legal guardian present, make sure to get permission before beginning the following procedure.
Pro Tip #1: Hold the baby at about a 30-45-degree angle, so the head is lower than the feet. This will allow gravity to assist, rather than hinder, your efforts.
Pro Tip #2: It's important that you keep the infant's body stabilized when doing the back slaps and chest thrusts. If you allow the infant's body to move downward with each slap or thrust, you'll minimize the effects necessary to force enough air up the trachea to remove the obstruction.
If you called 911, let them come anyway, so the infant can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining.
Pro Tip #3: If you did not call 911, it's always a good idea for you or someone else to take the infant into an urgent care center, hospital, or to see their physician to determine if more care is necessary.
This conscious infant choking procedure is extremely effective if you perform the back slaps and chest thrusts properly.
If you weren't able to remove the obstruction, the infant will go unconscious pretty quickly. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious infant choking procedure.
Young children are more prone to choking on small objects like toys, buttons, coins, and balloons. Food, too, is a bigger threat for children under four years old because they don't have a full set of teeth at that age, which means they aren't able to chew their food as well as older children.
The American Academy of Pediatrics (AAP) recommends not giving any firm, round food to children under four years old unless it is cut into smaller pieces – ideally smaller than half an inch. They also recommend keeping the following food items away from younger children:
According to the Consumer Product Safety Commission (CPSC), balloons represent the greatest threat to young children, as more have suffocated on non-inflated balloons and pieces of broken balloons than any other type of toy.
It's also important to remember to get permission from a parent or legal guardian, if present, before helping a choking infant or child.