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Discussion

Choking elder

Im a CNA but I can't find the CNA forum...

Today I just happened to glance into the day room and see an elder turning purple and trying to breathe but making no sound. I ran over and he wouldn't respond. I yelled for the cook to get the other CNA. He started coughing finally.

I was terrified.

This man is a Hoyer lift.

I had ZERO idea what to do in this situation. I've never been trained for this. This patient could not have been leaned forward or taken out of their chair.

Is there training for this beyond BLS?!

What do you do when a patient is choking that you can't perform a Heimlich on or lean them over?

Featured Replies

This is a training question that you need to ask of your employer.

Abdominal thrusts, as they are now called by AHA because of feud with Dr. Heimlich, are meant to use the abdomen to push up against the diaphragm and to rapidly expel air out of the trachea to clear the airway. The optimum position for doing this isn't always possible but the general premise applies to a number of different possible techniques, generally however you can push air out of the trachea will potentially work. I would avoid being too inventive however, hitting them in the abdomen with a sledgehammer might do the trick but it may also be frowned upon. Stay within your scope and follow what you've been trained to do.

  • Author

At that point the most advanced person in the facility was a CNA. So my training would have been to watch him die. ☹️

For residents in w/c's, you would position yourself behind the chair (sitting, standing, kneeling, whatever works), wrap your arms around the rib cage and administer abdominal or chest thrusts, making sure to check the mouth frequently for the dislodged item. If the resident passes out, slide them to the floor and begin chest compressions (no, not a safe transfer, but an injury is less of a concern than a patent airway) as you would for any unconscious adult.

The above is what *I* was trained in. If you have not covered this in your First Aid/CPR classes, then you need to find one that does. Maybe your facility could bring an instructor in to do an inservice for all the staff?

  • Author

Thank you. I finally got a hold of my friend last night who is an RN and this is basically what she said. She said whether they are in a bed or chair to find a way to get behind them and perform abdominal thrusts.

You can also push the wheelchair with its back against the wall, and lock the breaks. Then position yourself kneeling and facing the victim. That's how I was taught in BLS.

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