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| Choking in infants |
The Heimlich maneuver I discussed before is not usually done in infants. This is because abdominal thrusts are commonly associated with liver trauma hence are avoided. There are several maneuvers that can be done in infants. These are: Back blows, Chest thrusts, Jaw lift, and Ventilation.
Back blows are done by placing the infant in a head-down face-down position in your left forearm which is angulated to 60 degrees. The head and the neck should be stabilized. The infant’s forearm should be resting on your knee which is in flexed position. While in this position rapidly administer four back blows between the scapulae using the heel of your right hand.
If the back blows fail to remove the obstruction, do the chest thrusts. This is done with the infant in a supine position and lying on a firm surface. Using two fingers of your right hand, place them above the sternum and administer four rapid chest thrusts.
If there is still no breathing lift the jaw of the child in a sniffing position, open the mouth and inspect for presence of foreign body. Do not perform blind finger sweeps inside the child’s mouth as this may aggravate the situation.
Perform mouth-to-mouth resuscitation or bag-mask technique if the above procedures fail. Repeat this procedure several times or you can repeat everything altogether before proceeding to intubation. Intubation or cricothyroidotomy should be done by an expert. |
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