choking.html

CHOKING

Introduction

A foreign object that is stuck at the back of the throat may block the throat or cause muscular spasm.

Young children especially are prone to choking. A child may choke on food, or may put small objects into their mouth and cause a blockage of the airway.

If the blockage of the area airway is mild, the person should be able to clear it; if it is severe they will be unable to speak, cough, or breathe, and will eventually lose consciousness.

Mild Obstruction

Person able to speak, cry, cough or breathe
Good air exchange, but may wheeze between coughs
Responsive and can cough forcefully

Severe Obstruction

Person is unable to speak, cry, cough or breathe.
Poor or no air exchange
weak, ineffective cough
High pitched noise while inhaling or no noise at all
Increased respiratory difficulty
Turning blue
Clutching the neck wtih the thumb and fingers
Person will eventually become unconcious without assistance.

Treatment for Adult or Child

Your goal is to remove the obstruction if visible and to arrange urgent transport to the hospital if necessary.

If the obstruction is mild: Encourage them to continue coughing. Remove any obvious obstruction from the mouth.
If the obstruction is severe
* Check the mouth and remove any obvious obstruction
* If the obstruction is still present: Give up to 5 Abdominal Thrusts:

Stand or kneel behind the victim and wrap your arms around the victim's waist.
Make a fist with one hand
Place the thumb side of your fist against the victim's abdomen, in the midline, slightly above the navel and well below the breastbone.
grasp your fist with your other hand and press your fist into the victim's abdomen with a quick upward thrust
Repeat thrusts until the object is expelled from the airway or the victim becomes unresponsive
Give each new thrust with a separate distinct movement to relieve the obstruction.

* Check the mouth and remove any obvious obstruction
* If the obstruction does not clear after three cycles of abdominal thrusts

* Dial 911 for an ambulance
* Continue until help arrives

Treatment for Infants

Your goal is to remove the obstruction and to arrange urgent transport to the hospital if necessary.

If the infant is distressed, is unable to cry cough, or breathe:

* Lay them face down along your forearm, with their head low, and support the back and head.
* Give up to 5 Back Blows, with the heel of your hand.
* Check the infant's mouth; remove any obvious obstructions.
* Do not do a finger sweep of the mouth.

If the obstruction is still present:

* Turn the infant onto his back and give up to 5 Chest Thrusts
* Use two fingers, push inwards and upwards (towards the head) against the infants breastbone, one finger's breadthbelow the nipple line.
* The goal is to relieve the obstruction with each chest thrust rather than necessarily doing all five.
* Check the mouth, If the obstruction does not clear after three cycles of back blows and chest thrusts:

* Dial 911for an ambulance
* Continue until help arrives

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Holiday Safety
Christmas is a wonderful time, filled with joy and celebration.

It is also a time of increased risk for children. During the holidays, children are more likely to be exposed to: choking hazards, toy hazards, electrical hazards, food hazards, decoration hazards, poisoning hazards, and other hazards. Injuries to children often occur when there is a lack of adequate planning and supervision. Most holiday injuries to children are preventable, so always supervise your child! Here are some safety tips for protecting children during the holidays.

CHOKING HAZARDS:
1. Think large when selecting toys for children younger than 3 years old. Make sure that all toys and toy parts are larger than your child's mouth to prevent choking.
2. Children can be seriously injured or killed by inhaling, swallowing, or choking on small objects, such as small toy parts, marbles, or small balls.
3. Keep uninflated or broken balloons away from children. A child under age 8 can choke or suffocate on uninflated or broken balloons.

TOY HAZARDS:
1. Throw away all toy packaging right away so that it doesn't become become a choking or suffocation hazard.
2. Make sure that no part of a toy can break off and be swallowed by a child.
3. Don't buy toys with metal parts for a baby or toddler. Watch out for toys with sharp points or edges.
4. Keep batteries away from children, since they are toxic if swallowed. Batteries are also a choking hazard for small children.
5. Remember that any ball with a diameter up to one and three-quarters of an inch can easily cause choking in a child.
6. Avoid buying toys that shoot small objects into the air, since they often result in eye injuries. These arrows, darts, or pellets are also a choking hazard for young children. Each year, about 25,000 children are treated for injuries caused by BB guns and pellet guns.
7. Avoid buying toys that make loud or shrill noises.
8. Avoid items that could cause poisoning. Buy crayons, markers, and paint sets that are labeled nontoxic.
9. A toy chest without a lid is the safest choice for toy storage. A toy chest can hurt a child's fingers or hands if the lid closes suddenly. If a toy chest has a lid, it should have safe hinges that it can stay open in any position. A small child can suffocate if trapped inside of a closed toy chest. The chest should also have ventilation holes to prevent suffocation if a child becomes trapped inside.

ELECTRICAL HAZARDS:
1. Place electrical outlet covers on all outlets to reduce the risk of electrocution for children.
2. Do not overload electrical outlets with too many lights or appliances.
3. Never place electrical cords under carpets or behind drapes.
4. Throw away any electrical wires that are cracked, frayed, or bare.
5. Move electric curling irons and hair dryers far away from any sink or bathtub which might have water in it.
6. Turn off all lights, space heaters, and electrical appliances before you go to sleep or leave the house.

DECORATION HAZARDS:
1. Avoid decorations that have sharp edges or small, breakable parts.
2. Always supervise children near candles or open flames.
3. Never use lighted candles near drapes, curtains, wreaths, or trees.
4. Never leave burning candles unattended. Blow out all candles before going to sleep or leaving the house.

POISONING HAZARDS:
1. Lock up household cleaning products. The top two categories of childhood poisonings include household products and cosmetics.
2. Ask visitors to store their medications in high cabinets, out of reach of children.
3. Mistletoe and holiday berries are poisonous if swallowed.
4. Poinsettias can cause stomach irritation.
5. Post the telephone number of the local poison control center in an accessible place.

OTHER HAZARDS FOR CHILDREN:
1. Strings or cords are involved in numerous accidental strangulation deaths of infants and children. Cords from blinds, crib mobiles, hood cords, and pacifiers can accidentally strangle a child.
2. When visiting friends who have a dog, do not leave your child alone with the dog.
3. When visiting friends, remember that their homes may not be child-proofed. Ask to see if accessible cabinets are free of toxic items and medicines.
4. When cooking at home, keep children away from the stove. Use the back burners if possible. Turn he handles of pots and pans inward so that children cannot reach them.

Almost 3,000 people choke to death every year in the United States. An article in Oral Surgery, Oral Pathology, Oral Medicine reviewed hazards associated with foreign body ingestion and aspiration in the dental office. It discussed patient-related factors, preventive measures in the dental office, and clinical management of foreign body ingestion or aspiration.

Zitzmann NV, Elsasser S, Fried R, Marinello CP: Foreign body ingestion and aspiration. December 1999 88(6)657-660.

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