Long-Term Care

Choking, Part II

LTC Nursing Assistant Trainer, October 27, 2004

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Last week we discussed the procedures to help a choking victim. This week we'll continue that lesson, outlining special considerations for victims who are pregnant, obese or unconscious.

Immediate recognition, prompt action, and the use of proper techniques are critical to aiding choking victims. Remember-there are only about four minutes before there is possible brain damage and another four minutes before death.

When helping a choking victim who is pregnant or obese, do the following:

  • Stand behind the person, placing your arms under the person's armpits and around the chest, avoiding the lower part of the rib cage.
  • Place the thumb side of your fist in the middle of the breastbone and grasp your fist with the other hand.
  • Pull in quickly with your hands and arms. Repeat thrusts until the obstruction is cleared, emergency medical technicians arrive, or the person becomes unconscious.

In the case of an unconscious adult, first tell someone to call for emergency help while you check the victim. It is important to determine whether there are other life-threatening conditions involved-such as severe bleeding or a weak or absent pulse.

The following are some general procedures you should follow when aiding an unconscious choking victim.

  • Tap the victim's shoulder and shout to see if he or she is able to respond.
  • Without moving the victim, check to see if he or she is breathing by putting your head near the mouth and nose. Watch the chest to see if it rises and falls. Look, listen, and feel for signs of breathing for about five seconds.

Note: It is important to determine if the victim is breathing because if he or she is, that means the heart is beating and circulating blood to the brain.

  • If the victim is lying face down and not in a position where you can easily check for breathing, gently roll him or her onto the back. Be sure to support the head and back and keep the body in as straight a line as possible while you roll.
  • If breathing appears to have stopped, tilt the victims head back and lift the chin; then recheck to see if breathing has resumed.
  • Look, listen, and feel for signs of breathing for about five seconds.
  • If the victim is not breathing, check to see if an object is lodged in the back of the throat.
  • Attempt to remove the object (while wearing gloves) only if you can see it in the mouth.
  • If the victim is still not breathing, wait until help arrives. Do not administer any other treatment unless you have been properly trained to do so.

In addition to knowing these steps, make sure you are up to date on the most current and effective CPR procedures. Knowing what to do and how to do it could save a life.



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