What would you do?

[carolmaccas66, BSN, RN]

I was watcing a real-life show re medical emergencies. The phone operator, who was advising the person at the actual emergency where a woman was choking, said NOT to hit her on the back, because if the person that is choking has swallowed food (or an object), it can make the object slide down their trachea more and cut off their airway completely.

I have never been taught this. We have only recently been taught this is what you keep doing, until emergency services arrive. One of the senior RNs I work with was only doing this the other day when an elderly patient we had choked on a dry, coconut dessert (which she was guzzling down too fast anyway). There isn't anything else you CAN do is there except keep pummelling them on the back to try & dislodge whatever is blocking their airway.

What would you do, or what have u been taught to do? Just interested to hear different view points.

Thanx

[Student2Registered]

Heimlich maneuver, sorry if I spelled it wrong...

[carolmaccas66, BSN, RN]

Heimlich maneuver, sorry if I spelled it wrong...

We were taught not to do that either, because it quite often doesn't work! We have just been told to keep slapping the person on the back, very hard to dislodge the object.

[resumecpr]

If you work in an American hospital in the United States, you are required to follow the hospital policy for Life Support Measures, which in most cases is guided by the American Heart Association (AHA).

It is my understanding that all staff who have direct patient contact are to be certified with BLS (CPR/AED) via the AHA. This class teaches you the skills that have been proven through evidence based practice to be effective for a victim who is choking. If they are awake, you perform the heimlich maneuver. Chances are, if the heimlich hasn't worked in your experience, you may not be not doing it right. If they become unconscious, you begin CPR.

I suggest you follow up with your hospital's policy on this matter.

[carolmaccas66, BSN, RN]

The senior nurse followed hospital policy and slapped the patient on the back. The victim was not unconscious, otherwise we would have started CPR, and called the MET team (of course).

I'm just interested as to what others have been taught re this.

[Davey Do]

Okay. This is a discussion. So, I'm basing my answer on my understanding of this particular situation.

With that said, I believe "choking " is the key word here. If there is no exchange of air, then the Heimlich manuever is attempted. If there is an exchange of air (e.g. coughing), then basically nothing is done. Aside from alerting EMS, monitoring the Individual, etc.

To my recollection, back blows are used only on infants.

Dave

[skittlebear]

I have been taught not to pat a choking patient on the back, but to perform the heimlich maneuver instead. Of course, if the patient is coughing, that is a good sign. Let them cough and try to expel the object. Sometimes, it's hard to just stand their and let the patient cough and that may feel awkward so what does one do in the meantime? Pat the person on the back, lol. I have been guilty of it a few times but now will intervene when absolutely necessary. Heimlich Maneuver.

[skittlebear]

Okay. This is a discussion. So, I'm basing my answer on my understanding of this particular situation.

With that said, I believe "choking " is the key word here. If there is no exchange of air, then the Heimlich manuever is attempted. If there is an exchange of air (e.g. coughing), then basically nothing is done. Aside from alerting EMS, monitoring the Individual, etc.

To my recollection, back blows are used only on infants.

Dave

Yes, that is what I was trying to say but you said it much better. I really need some sleep : )

[NoviceRN10]

Okay. This is a discussion. So, I'm basing my answer on my understanding of this particular situation.

With that said, I believe "choking " is the key word here. If there is no exchange of air, then the Heimlich manuever is attempted. If there is an exchange of air (e.g. coughing), then basically nothing is done. Aside from alerting EMS, monitoring the Individual, etc.

To my recollection, back blows are used only on infants.

Dave

I agree, never whack a person on the back, especially if they are making noise and obviously getting some air.

[DizzyLizzyNurse]

We do the Heimlich Maneuver, only if someone can't breath, speak, or cough. I was taught to never pound someone on the back because it can make it slip farther down. You only pat a baby's back while holding them in a downwards position.

[SCnurse2010]

If they are moving air you don't do anything. I agree that it is VERY difficult to watch someone struggle like that! The few times it's happened to me, I offer verbal encouragement and stroke their arm, shoulder or back gently just to offer reassurance. Only once have I had someone go from making noise to full on choking and the heimlich worked just fine.

[carolmaccas66, BSN, RN]

Very interesting responses.

As I said, one senior RN was doing back blows on an elderly lady. The lady was wheezing and trying to breathe better, but still breathing.

The person in the real life scenario could NOT breathe at all and they still said not to do back blows (I don't know what happened in the end cos I had to go to work!)

Next time I do a refresher course, I will bring this up.

Thank you.