critical care medicine
How To Treat the Choking Conscious Infant
Step by Step Description of Procedure
Determine if there is severe airway obstruction, which may endanger the infant’s life. Look for signs of severe airway obstruction, such as the inability to cry audibly, cough effectively, or breathe adequately (eg, stridor, retractions, cyanosis). If the infant has a strong cry or is coughing hard, do not do these procedures. If you have determined that the infant has severe airway obstruction, proceed with the following procedures. Tell someone to call 911 while you begin first aid. If you are alone, shout for help and begin first aid. Hold the infant face-down along your forearm using your thigh or lap for support. Hold the infant’s chest in your hand and open the jaw by pulling the mandible with your fingers. Point the infant’s head downward and lower than the body. Give up to 5 quick, forceful back blows between the infant’s shoulder blades using the palm of your free hand. Check the mouth to see whether the aspirated foreign body is visible; if it can be easily removed, remove it. If the object does not come out of the airway after 5 back blows, turn the infant face-up. Hold the infant face-up along your forearm using your thigh or lap for support. Hold the head in your hand with the head lower than the torso. Place 2 fingers on the middle of the infant’s sternum just below the nipples. Avoid the lower ribs or the tip of the sternum. Give up to 5 quick thrusts, compressing the chest about 1/3 to ½ the depth of the chest—usually about 1.5 to 4 cm (0.5 to 1.5 inches) for each thrust. Continue to deliver 5 back blows followed by 5 chest thrusts until the object is dislodged or the infant becomes unconscious. Do not try to grasp and pull out the object if the infant is conscious. If the infant becomes unresponsive (unconscious), shout for help and begin infant Cardiopulmonary Resuscitation (CPR) in Adults (CPR). If you are alone, after 1 minute of CPR call 911. If the infant is unconscious and you can see the object blocking the airway, try to remove it with a finger. Try to remove the object only if you can see it. 