When do you intervene when food is lodged?

[BumblebeeinNC]

I'm really confused as to when you are supposed to intervene when someone has food lodged in their throat. I am beginning nursing school in two weeks and I recently got my CNA certification and am CPR certified. The CPR protocol says that if the person can speak and breathe then leave them alone. The newest info also says do NOT do a blind finger sweep.

My 13 yo son runs downstairs telling us he is choking on a dum dum sucker. It had come off of the stick. He runs to the kitchen sink and is coughing and trying to spit it up somehow and says he feels it stuck low in his throat like at the opening of the esophagus. I tell my husband that he is not choking b/c he can talk and breathe. I begin to tell our son to relax and lets get something to drink to see if it will go down. My husband then sticks his finger in our son's throat (to do a blind sweep for the object) causing our son to throw up and out pops the sucker. Whew, I am relieved that he gets it out but now I feel really stupid that I wasnt able to help. I am starting nursing school in two weeks for pete's sake!

So, I need some experienced advice on when to intervene when an object is lodged but they are not officially "choking" yet. Thanks!

[XB9S, BSN, MSN, EdD, RN, APN]

ILCOR's official guidence

http://resus.org.uk/pages/achkalgo.pdf

http://resus.org.uk/pages/pchkalgo.pdf

[glad2bhere]

I wou9ld be concerned if I were under this nurses care. What do you think?

[glad2bhere]

Thanks Sharrie......I knew I was thinking correctly....

[Esme12, ASN, BSN, RN]

Or cause spontaneous amputation of said husbands finger

HA! That's funny! But,like you said, your son was "telling" you has was choking. In reality he had a food bolus or food in the "food pipe" esophagus. People use the term choking for feeling something stuck in their throat. Your husband was very lucky that he did shove the lollipop down the trachea if it was just in the back of his throat. That would have caused him to really choke and those stupid lollipops are perfect obstructors!

The lollipop popped out when he vomited because it was in the esophagus not trachea. If they are coughing and talking leave them be! and calm them down. The heimlich maneuver is for an obstructed airway.....they can't talk. I have heard of using bread to help facilitate noving the stuck object to the stomach. I have worked in ED's that utilized meat tenderizer to disolve meat in the esophagus.

But first and foremost let them clear their own airway if they are talking and coughing........just HOLD THEIR HAND!

[Nicky30, BSN, RN]

In Australia we have used Coca-Cola to dissolve food in the oesophagus or IV glucose (to stimulate peristalsis).

I have two memorable choking scenarios - the first definitely qualified for intervention, unfortunately the food was lodged too far down and we were unsuccessful.

The second was my daughter and it was the scariest thing seeing her little face go red and then pale trying to get rid of the obstruction. Due to her age it was the swift blows to her back and the obstruction (a partially chewed biscuit) was dislodged. That first breath of air was like heaven on earth.

Nicky.

[FlyingScot, RN]

Your husband was VERY lucky your son didn't aspirate when he vomited. Maybe it's time for him to take a BLS class.

[grandmawrinkle]

Your husband was VERY lucky your son didn't aspirate when he vomited. Maybe it's time for him to take a BLS class.

Why do you think that a healthy, alert 13 YO vomiting is an aspiration risk? That's like saying that me barfing in the toilet when I have the stomach flu is lucky to not have aspirated. Just because you barf doesn't mean you are at risk for aspiration. That's why we have an epiglottis.

[FlyingScot, RN]

Gee I don't know maybe because I've seen it happen. When a person is choking often there is a disconnect in the usual timing of the epiglottis closing/opening while the patient is gasping for air. So yes you can have an awake, alert person aspirate. Most people have experienced on occasion something "going down the wrong way" causing them to choke. Apparently you haven't. I'm a bit mystified as to the hostile tone in your post. Am I misinterpreting it?

[PAROPPY, BSN, RN]

Rule of thumb is don't intervene until the victim is unable to breathe. When it's your own kid though... all knowledge goes out the window. Good for you though keeping your cool during the situation and doing what you learned as the right the thing to do. I've watched my husband to a blind finger sweep to our one y/o and I almost keeled over. That's probably why are husbands aren't nurses!!