Long-Term Care

Choking, Part I

LTC Nursing Assistant Trainer, October 21, 2004

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Choking is the sixth leading cause of accidental death in adults. When a piece of meat or other object becomes lodged in the throat and prevents breathing, it is important to act quickly to help dislodge it. A foreign body airway obstruction is a life-threatening emergency. If the obstruction is not removed, it will cause brain damage within four minutes and death within eight.

Foreign objects that become lodged in the throat may completely or partially block the airway. When the airway is partially blocked, breathing is possible, although it may be very difficult. Do not pat a choking person on the back, as this can force the object further into the throat and cause the airway to become completely blocked.

If a choking person is able to breathe, allow him or her to try to cough up the object on their own. However, if the situation worsens and the person appears unable to get enough air-indicated by a weak cough, high pitched wheezes and a bluish color around the lips-treat him or her as you would someone with a complete obstruction.

Here are the steps for expelling an object that is causing an airway blockage:

 Determine whether the person is choking by asking, "Are you choking?"
 Shout "Help!" if the person cannot speak, cough, or breathe. This will attract others, who can call 911 or your facility's emergency number.
 Tell the person you are going to help or, if others are already at the victim's side, ask, "Can I help?"
 Stand behind the person and wrap your arms around the waist.
 Make a fist with one hand, enclosing the thumb.
 Place the thumb side of the fist against the middle of the person's abdomen just above the navel and well below the lower tip of the breastbone.
 Clasp your other hand over your fist and pull in forcefully with a quick upward thrust, keeping your elbows out.
 Repeat thrusts until the obstruction is cleared, emergency medical technicians arrive, or the person becomes unconscious.

Next week we'll discuss how to help a choking victim who is pregnant, obese, or unconscious.



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