First Aid For Choking And CPR – 12 Months And Older (not for infants) – *This should be on everyone’s fridge!*
Step 1: Assess the situation quickly.
If a child is suddenly unable to cry, cough, or speak, something is probably blocking her airway, and you’ll need to help her get it out. She may make odd noises or no sound at all while opening her mouth. Her skin may turn bright red or blue.
If she’s coughing or gagging, it means her airway is only partially blocked. If that’s the case, encourage her to cough. Coughing is the most effective way to dislodge a blockage. (Do Not hit back or do thrusts)
If the child isn’t able to cough up the object, ask someone to call 911 or the local emergency number as you begin back blows and chest thrusts (see step 2, below).
If you’re alone with the child, give two minutes of care, then call 911.
On the other hand, if you suspect that the child’s airway is closed because her throat has swollen shut, call 911 immediately. She may be having an allergic reaction – to food or to an insect bite, for example – or she may have an illness, such as croup.
Also call 911 right away if the child is at high risk for heart problems.
Step 2: Try to dislodge the object with back blows and abdominal thrusts.
First do back blows
If a child is conscious but can’t cough, talk, or breathe, or is beginning to turn blue, stand or kneel slightly behind him. Provide support by placing one arm diagonally across his chest and lean him forward.
Firmly strike the child between the shoulder blades with the heel of your other hand. Each back blow should be a separate and distinct attempt to dislodge the obstruction. (Remember a bruise on their upper back is minor compared to choking to death!)
Give five of these back blows.
Then do abdominal thrusts
Stand or kneel behind the child and wrap your arms around his waist.
Locate his belly button with one or two fingers. Make a fist with the other hand and place the thumb side against the middle of the child’s abdomen, just above the navel and well below the lower tip of his breastbone.
Grab your fist with your other hand and give five quick, upward thrusts into the abdomen. Each abdominal thrust should be a separate and distinct attempt to dislodge the obstruction.
Repeat back blows and abdominal thrusts
Continue alternating five back blows and five abdominal thrusts until the object is forced out or the child starts to cough forcefully. If he’s coughing, encourage him to cough up the object.
If the child becomes unconscious
If a child who is choking on something becomes unconscious stop thrusts, you’ll need to do what’s called modified CPR. Here’s how to do modified CPR on a child:
Place the child on his back on a firm, flat surface. Kneel beside his upper chest. Place the heel of one hand on his sternum (breastbone), at the center of his chest. Place your other hand directly on top of the first hand. Try to keep your fingers off the chest by interlacing them or holding them upward.
Perform 30 compressions by pushing the child’s sternum down about 2 inches. Allow the chest to return to its normal position before starting the next compression.
Open the child’s mouth and look for an object. If you see something, remove it with your fingers.
Next, give him two rescue breaths. If the breaths don’t go in (you don’t see his chest rise), repeat the cycle of giving 30 compressions, checking for the object, and trying to give two rescue breaths until the object is removed, the child starts to breathe on his own, or help arrives.
How to Give CPR
CPR stands for cardiopulmonary resuscitation. This is the lifesaving measure you can take to save someone who shows no signs of life (consciousness or effective breathing).
CPR uses chest compressions and “rescue” breaths to make oxygen-rich blood circulate through the brain and other vital organs until emergency medical personnel arrive. Keeping oxygenated blood circulating helps prevent brain damage – which can occur within a few minutes – and death.
CPR isn’t hard to do. Follow these steps:
Step 1: Check the child’s condition.
Is the child conscious? Tap on the child’s shoulder and call out. If she doesn’t respond, have someone call 911 or the local emergency number. (If you’re alone with the child, give two minutes of care as described below, then call 911 yourself.)
Swiftly but gently place the child on her back on a firm, flat surface.
Make sure she isn’t bleeding severely. If she is, take measures to stop the bleeding by applying pressure to the area. Don’t administer CPR until the bleeding is under control.
Step 2: Open the child’s airway.
Tilt the child’s head back with one hand and lift his chin slightly with the other. This will open his airway.
Check for signs of breathing for no more than ten seconds.
To check his breathing, put your head down next to his mouth, looking toward his feet. Look to see whether his chest is rising, and listen for breathing sounds. If he’s breathing, you should be able to feel his breath on your cheek.
Step 3: Give two “rescue” breaths.
If the child isn’t breathing, give her two breaths, each lasting just one second. Pinch the child’s nose shut, place your mouth over hers, and exhale into her lungs until you see her chest rise.
If her chest doesn’t rise, her airway is blocked. Give her first aid for choking, described above.
If the breaths go in, give the child two rescue breaths in a row, pausing between breaths to let the air flow back out.
Step 4: Do 30 chest compressions.
Kneel beside the child’s upper chest. Place the heel of one of your hands on the child’s sternum (breastbone) at the center of her chest. Place your other hand directly on top of the first hand. Try to keep your fingers off her chest by interlacing them or holding them upward.
To do a chest compression, push the child’s sternum down about 2 inches. Allow the chest to return to its normal position before starting the next compression.
Do 30 chest compressions at the rate of 100 per minute. Then give the child two rescue breaths (step 3, above). (Each cycle of chest compressions and recue breaths should take about 24 seconds.)
Step 5: Repeat compressions and breaths.
Repeat the sequence of 30 chest compressions and two breaths. If you’re alone with the child, call 911 or the local emergency number after two minutes of care.
Continue the sequence of chest compressions and rescue breaths until help arrives, you find an obvious sign of life, an AED (automated external defibrillator) is ready to use, the scene becomes unsafe, or you are too exhausted to continue.
Even if the child seems fine by the time help arrives, a doctor will need to check her to make sure that her airway is completely clear and she hasn’t sustained any internal injuries.