First Aid for the Choking Child

Abstract

The aspiration of a foreign body is a common hazard and the second greatest cause of home accidental death in children less than 5 years old.1 The National Safety Council reported more than 450 childhood deaths in 1978 caused by the accidental ingestion or inhalation of objects or foods resulting in the obstruction of respiratory passages. Pediatricians must emphasize the dangers of this emergency situation and teach first aid measures essential for proper evaluation and treatment. Much existing data on treating the choking child are anecdotal. Review of the available literature suggests that the following approach be adopted. Any foreign body in the upper airway is an immediate threat to life and requires urgent removal. If the child can speak or breathe and is coughing, any maneuvers are dangerous and unnecessary. If the choking child is unable to breathe or make a sound, turn the child's head, place the child face down over your knees, and forcefully give four back blows. If this procedure fails to propel the object from the windpipe deliver four chest thrusts rapidly. Repeat these procedures as necessary if there is no response. Finger probing of the mouth should be attempted only if the foreign body is visualized. If the victim is an infant, place him over your forearm for the maneuvers. Older children can be placed on the rescuer's lap or on the floor. Pediatricians should familiarize themselves with recommended methods of cardiopulmonary resuscitation (CPR) for the various age groups.2 Remember, if the child is able to breathe and make sounds, and is coughing, these maneuvers are not needed.