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All Choked Up

Jan 1, 2007
2007 / December-January 2007

While attending a recent family gathering, my brother, Larry, rescued another family member from choking due to an obstructed airway. Tom had been eating dinner when my brother noticed that he was choking. Larry performed the Heimlich maneuver and the obstruction, a piece of filet mignon, was cleared. Tom was grateful to be breathing again — and alive.

Would you be able to act and save a life? What if you were traveling alone and started to choke? Could you save yourself? What if the victim who was choking became unconscious? What if a pregnant woman was choking? Could you help her? The answer, if you pay attention, could be “yes” to all these questions.

Choking happens when a foreign body becomes trapped in the throat or windpipe, blocking the flow of air. Because choking cuts off the flow of oxygen to the brain, first aid needs to be administered to the victim immediately.

Choking is among the true medical emergencies that require fast, appropriate action. Emergency medical teams may not arrive in time to save the choking victim’s life. The brain is extremely sensitive to the lack of oxygen that occurs when an airway is completely blocked. Without oxygen, the brain begins to die within four to six minutes. Irreversible brain death can occur in as little as 10 minutes when the brain is deprived of oxygen.

Instinctively when choking, victims clutch their hands to their throat. If the person does not give that signal, look for an inability to talk, difficulty breathing or noisy breathing, inability to cough forcefully, skin or lips turning blue or dusky in color, or loss of consciousness.

If signs point to a choking incident, prepare to perform the Heimlich maneuver, which lifts the diaphragm and forces enough air from the lungs to create an artificial cough. The cough is intended to move and expel the foreign body obstructing the airway. The Heimlich maneuver can be done on adults and children as young as 1. If you are the only rescuer, perform the Heimlich maneuver before calling 911 (in the United States) or your local emergency number for help. If another person is available, direct that person to call for help while you perform the Heimlich maneuver.

Never hide the fact that you are choking and never leave the area out of embarrassment. Choking victims have been known to leave the table in a restaurant only to be found later in the bathroom having choked to death when help could have saved their lives. Studies show that another person was present at the time of 85 percent of choking deaths in the United States. If you are ever in this situation, you need to act. Everyone should be trained in the simple yet life-saving techniques of the Heimlich maneuver and CPR.

For more information, visit http://americanheart.org.

Heimlich Helper

To perform the Heimlich maneuver on someone else:

Stand behind the person.Wrap your arms around their waist. Tip the person forward slightly. Make a fist with one hand with your thumb tucked into the fist. Position your fist slightly above the person’s navel. Grasp the fist of the other hand. Press hard onto the abdomen with a quick, upward thrust, almost as if trying to lift the person up. Repeat until the blockage is dislodged.

If you are alone in your hotel room:

Perform the Heimlich on yourself. Place a fist above your navel. Grasp your fist with the other hand and bend over a hard surface such as a chair or a counter. Shove your fist inward and upward.

To perform the Heimlich maneuver on a pregnant woman or obese person:

Place your hands a little higher — at the base of the breast bone, just above the joining of the upper ribs. Proceed as with the standard Heimlich maneuver, pressing hard into the chest with a quick thrust.

To clear the airway of an unconscious person:

Gently lower the person on their back onto the floor. Straddle the victim and place the heel of your hand against the middle of the abdomen, just below the ribs. Place your other hand on top and press inward and upward five times with both hands. If the airway clears and the victim is still unresponsive, begin CPR.

To clear the airway of a choking infant:

Sit down and hold the infant face down on your forearm, which is resting on your thigh. Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and back blows should release the blocking object. If this does not work, hold the infant face up on your forearm with the head lower than the trunk. Using two fingers placed at the center of the infant’s breast bone, give five quick chest compressions.


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