Choking (Airway Obstruction From a Foreign Object)
Choking caused from a Foreign Body Airway Obstruction can be a partial or complete blockage of the breathing tubes to the lungs. It is a life-threatening condition that must be treated immediately. If the obstruction is partial the casualty will have an effective cough or crying in young children, and if the obstruction is causing a complete blockage the casualty will have an ineffective cough and be making no sounds.
Common causes of choking include:
Fish or chicken bones.
Food that has not been chewed properly.
Any small objects that children can put into their mouths.
Vomitus, especially in the unconscious casualty.
Partial Obstruction with Effective Cough
Difficulty breathing.
Some escape of air can be felt from the mouth.
Persistent cough.
Wheezing or noisy breathing (stridor).
Becomes cyanotic (bluish colour to skin and lips).
Anxious.
Children and infants may have flaring of the nostrils.
Children and infants may have in-drawing of the tissues above the sternum and in between the ribs.
Follow the DRSABCD emergency action plan
Encourage the casualty to keep coughing.
If the obstruction does not clear call 000 for an ambulance.
Reassure casualty and continue to give encouragement to cough.
DO NOT slap a casualty with a partial obstruction on the back.
If the casualty’s condition does not improve, treat as a complete obstruction.
DO NOT slap the casualty on the back.
DO NOT reach into the casualty’s mouth to dislodge the object; this may force the object further down the casualty’s throat.
Complete Obstruction with Ineffective Cough
Unable to breath, speak or cough.
Becoming cyanotic (bluish colour to skin and lips).
Holding of the throat (universal choking sign).
Agitated and distressed.
No breath sounds and no escape of air from nose and/or mouth.
Rapid loss of consciousness.
Conscious Casualty
Follow the DRSABCD emergency action plan.
Call 000 for an ambulance .
Stand slightly behind the casualty and to the side.
Support the chest with one hand and lean the casualty forward.
Give up to five sharp back blows with the heel of one hand in the middle of the back between the shoulder blades.
If the casualty is an infant place in a head downwards position prior to delivering back blows i.e. across your lap.
Check the casualty’s mouth after each back blow to see if the obstruction has been relieved.
If the obstruction is still not relieved, continue alternating five back blows with five chest thrusts until the ambulance arrives.
Unconscious Casualty
Follow the DRSABCD emergency action plan.
The finger sweep can be used in the unconscious casualty with an obstructed airway if solid material is visible in the airway.
Call 000 for an ambulance – Call First and Call Fast.
Commence CPR.
If the casualty becomes unconscious and is not breathing normally call 000 for an ambulance urgently and commence CPR.
