What to do first if a choking child becomes unconscious

[nurseglitter]

:clown:Hey everyone, my friends and I are a bit confused with this question. I hope someone out there can help.

Question: A child choking on food becomes unconscious what do you do FIRST?

A- Check for airway

B- Chest compressions

C- Check for pulse.

I think we should check for airway, my friend says check for pulse and our other friend says to start chest compressions. Which one is correct?

[wombatbullant]

TELL ME When you lernt CPR did anyone hear the bit about check the airway first and make sure it is clear, Or how about DABC. Danger, AIRWAYS, Breathing ,circulation.

[CT Pixie, BSN, RN]

DABC..I learned in EMT school..You need to make sure the scene is safe (Danger). But just because the child becomes unconscious does not mean their airway is totally obtructed..they might be getting some O2..but not enough..hense the unconsciousness.

Check the airway, is the foeign body visible? If so finger sweep to get it out..if not..position head and give rescue breaths first..A B C..

[flashpoint]

http://www.americanheart.org/presenter.jhtml?identifier=3025002

Relief of Choking in Children

Signs of Choking

Choking occurs when something blocks the airway. When the airway is completely blocked, the child cannot breathe. Choking can be a frightening emergency. But if you act quickly, you can help the child breathe.

If the child can speak or cough loudly, the child's airway is only partly blocked. You should not try to open the airway. If you are worried about the child's breathing, phone 9-1-1.

Signs of choking in the child with a completely blocked airway are

The child suddenly begins to cough, gag or have high-pitched, noisy breathing

An older child may make the choking sign (holding the neck with one or both hands)

The child has bluish lips or skin

Actions to Relieve Choking in a Child

When a child is choking and can't breathe or speak, you must give abdominal thrusts (the Heimlich maneuver). The Heimlich maneuver pushes air from the child's lungs like a cough. This can help remove the blocking object. You should give abdominal thrusts until the object is forced out or the victim becomes unresponsive.

If you think a child is choking, ask the child "Are you choking?" If he nods, tell him you are going to help.

Kneel or stand firmly behind him and wrap your arms around him so that your hands are in front.

Make a fist with one hand.

Put the thumb side of your fist slightly above the navel (belly button) and well below the breastbone.

Grasp the fist with your other hand and give quick upward thrusts into his abdomen.

Give thrusts until the object is forced out and he can breathe, cough, or talk or until he stops responding.

If the choking is not relieved, the child will become unresponsive. When the child becomes unresponsive, shout for help, lower the child to the ground, and start CPR. If someone else is present, send that person to phone 9-1-1 while you start CPR.

The steps of CPR of the child who has become unresponsive after choking are the same, with one addition.

Yell for help. If someone comes, send that person to phone your emergency response number (or 911) and get the AED if available.

Lower the victim to the ground, faceup. If you are alone with the child victim, start the steps of CPR.

Every time you open the airway to give breaths, open the victim's mouth wide and look for the object. If you see an object, remove it with your fingers. If you do not see an object, keep giving sets of 30 compressions and two breaths until an AED arrives, the victim starts to move, or trained help takes over.

After about five cycles or two minutes, if you are alone, leave the child victim to call your emergency response number (or 911) and get the AED if available.

Chest compressions may force the object out. If you are alone with the child and these steps don't work after about one minute, phone 9-1-1.

[Queen Tiye, CNA]

i just received my bls a few weeks ago and new guidelines say to give to breathes first, no longer checking the airway.

actually:

1) open the airway

2) check for breathing and watch to see if chest is rising

3) give two breathes

4) take pulse

5) chest compressions -- to dislodge what is in the airway. new bls guidelines no longer support pressing on the diaphragm because of potential damage, according to my instructor.

doing rescue breathes first wasn't logical to me, i'd want to check airway first, and wouldn't blowing push blockage a bit further?

[NurseLoveJoy88, ASN, RN]

Airway. We may be able to dislodge the obstruction. BTW- It doesn't take 10 secs to check airway.

[annietart]

Preform a jaw thrust or chin lift to open the airways and give 2 rescue breaths. If the breaths don't go in give 30 seconds of compressions and than check to see if the obstruction is gone. Repeat until airway is clear.

[canoehead, BSN, RN]

All options are wrong...call a code.

[NAURN]

NOTHING is done until you check the airway. Depending on age of child, you may do back blows or abd thrusts.... unless this has been changed in the new CPR guidelines.

THEN- once all those are in process, you can call a code.

[chare]

one of the most radical changes included in the 2010 aha guidelines for cpr and ecc science which were released last october was changing the sequence of events from abc to cab. while this makes most sense in the adult victim of sudden cardiac arrest, the aha opted to teach this cycle for all age groups to simplify instruction. all of the guidelines are available on line for review.

the new course material is scheduled to be released starting late spring or early summer. in the past most aha training centers started teaching the new material after updating instructors and before the new material was available.

the foreign-body airway obstruction (choking) section contained in part 13: pediatric basic life support states the following:

if the victim becomes unresponsive, start cpr with chest compressions (do not perform a pulse check). after 30 chest compressions, open the airway. if you see a foreign body, remove it but do not perform blind finger sweeps because they may push obstructing objects farther into the pharynx and may damage the oropharynx. attempt to give 2 breaths and continue with cycles of chest compressions and ventilations until the object is expelled. after 2 minutes, if no one has already done so, activate the emergency response system.