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| Choking |
Choking usually results from foreign body aspiration in the form of small toys, pieces of food like nuts and candies, put inside the nose by little children. These things obstruct the airway when it lodge on the bronchus and the airway obstruction is a medical emergency.
Initially the condition can be asymptomatic or it may cause a mild cough.When severe there can be coughing out of blood with either partial or complete obstruction of the lungs. A chest x-ray can be done but a normal result does not rule out foreign body aspiration nor does it help in improving the condition of the child.
If the child is conscious nothing should be done to dislodge the foreign body. He should be immediately brought to a surgeon who can do laryngoscopy or bronchoscopy.
If the child is unconscious because of airway obstruction, he should be resuscitated immediately by applying up to eight abdominal thrusts (Heimlich maneuver) until the foreign body is dislodged.
This maneuver is done in several ways depending on the age of the child. In a child less than 7 years old, he should placed on his back with you on left his side. Position the heel of your left hand on his abdomen between the umbilicus and the rib cage. Using your hand perform rapid inward and upward thrusts.
In an older child the procedure can be with the child in the same position as above or in sitting or standing position. In the sitting or standing position you should stand behind him, wrap your arms around his waist, and make a fist with your right hand. Your left hand should be grasping the right while making a quick upward thrust in the abdomen. Make sure that the thumb of the right fist is against his midline abdomen slightly below the xiphoid process and above the umbilicus.
This procedure can be done alternately with mouth-to-mouth resuscitation if there is no spontaneous respiration. If the maneuver fails open the mouth and lift the jaw forward.This position improves the respiration in an unconscious child. The head of the child is placed in a “sniffing position” avoiding hyperextension to prevent airway obstruction. A foreign body inside the mouth can be manually extracted using a forcep.
If everything fails then intubation or cricothyroidotomy should be done. This must be done by a surgeon. |
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