RESPIRATOR

Y
EMERGENCI
ES
CHOKING
Introduction

This normally occurs when the airway

is partially or totally obstructed by a:
Large swallowed object
When something goes down the
windpipe rather than the food passage
Muscular spasm
Choking
 UNCONSCIOUS
 JAW FALLS BACK
 AIRWAY OBSTRUCTION

 JAW THURST
 AIRWAY IS MAINTAINED
Signs and symptoms
 Difficulty in breathing, rate and depth
increases
 Frothing at the mouth
 Blueness of lips and finger nails
 Confusion
 Casualty will be unable to speak
 Congestion of the face and neck veins
becoming prominent
 Possible unconsciousness
Treatment
 Remove any debris or false teeth from the
casualty’s mouth and encourage the casualty to
cough.
 Help the casualty to bend over with the head
lower than the lungs. Slap the casualty smartly
between the shoulder blades with the heel of the
hand up to five times: each slap should be hard
enough to remove the obstruction by itself.
 Check the mouth to see if the obstruction has
been dislodged. If it has not, you may be able to
remove it by performing abdominal thrust.
Cont’d
a. For the unconscious choking
casualty:
 Turn the casualty on the back, open the airway
and begin artificial ventilation. If this is not
successful, roll the casualty on to the side facing
you with the chest against your thigh and the head
well back and perform up to five back slaps.
 Check the mouth to see if the obstruction has
been dislodged. If it had, hook it out with your
finger. If it has not, turn the casualty on to the
back with the head in the open airway position
 5
Abdominal
Thrusts
 5
Back blows
Cont’d
 Check the mouth again to see if the
obstruction has been dislodged.
 Ifchoking persists, reposition the casualty’s
head and attempt artificial ventilation.
Then repeat steps 1 to 4 as necessary.
 When the obstruction has been removed
and the casualty is breathing normally,
place in the recovery position and take to
hospital.
Cont’d

b. For children:
 Big children and small adults are
treated in the same way as above.
Small child
 Sit in the chair or kneel on one
knee and lay the child over your
knee, head down.
Cont’d

 Support the chest with one hand and slap the

child smartly between the shoulder blades up
to five times with your other hand.
 Ifthis does not dislodge the obstruction, it
may be necessary to perform abdominal
thrust.
 Ifthe child is or become unconscious, place on
a firm surface and follow sequence described
for unconscious adults.
Cont’d

c. For infants:
 Treatment method for infants is the same as for children
but much lighter pressure is used and the positions for
back slapping and abdominal thrust are different.
 Lay the infant’s head downward with the chest and
abdomen lying along your forearm and use your arm to
support the head and chest. Slap the infant smartly
between the shoulders up to five times.
 If back slapping does not dislodge the obstruction it may
be necessary to perform abdominal thrust.
Abdominal thrust for infants
 Placethe infant on a firm surface with the
head in the open airway position.
 Placethe first two (index and middle)
fingers of one hand on the upper abdomen,
between the navel and the breastbone and
press with a quick forward and downward
movement.
 Repeat up to five times as necessary; each
thrust must be hard enough to dislodge the
obstruction.
 5
Chest Thrusts
Cont’d

 Check the mouth again. If the obstruction is

visible but not coughed out, hook it out with your
fingers.
 If choking is not relieved, repeat back slaps (up to
five times) and abdominal thrust (up to five
times). If casualty becomes unconscious, treat as
described earlier.
 The casualty may begin breathing again at any
stage. When this happens, advise the casualty to
sit quietly and give sips of water as necessary.
Precautions
Use extreme caution when removing
an obstruction from the mouth of an
infant.
Only put your finger in the mouth, if
you can see the obstruction and
there is no danger of pushing the
obstruction further down the throat.
 The Do and Don’ts for First Aid
Treatment

DIAGNOSIS

CHOKING • Slap the victim back’s • Remain calm and encourage the victim to keep
hard. coughing to try and clear the blockage.

• Using your fingers to • Stand slightly behind the person to one side.
force out the item out of • Support their chest with one hand. Lean the person
the victim’s mouth. forward so that the object blocking the airway will
come out of their mouth, rather than going further
down.
• Give at least 5 sharp blows between the person’s
shoulder blades with the heel on your hand.
Stop after each blows to check if the blockage has
ASK! Are you choking? cleared. If not, give up to five abdominal thrusts.
If the victim able to talk,
groan, wheeze or cough, he
is partially choked.
 The Do and Don’ts for First Aid Treatment

DIAGNOSIS

CHOKING • Using your fingers to Steps in Abdominal thrusts

force out the item out of 1. Stand behind the person who is choking.
the victim’s mouth. 2. Place your arms around the waist and bend them well
forward.
3. Clench your fist and place it right and place it right
above the person’s navel (belly button)
4. Place your other hand on top, thrust both hands
backwards into their stomach with a hard, upward
movement.

Complete blockage Do it five times (1 cycle), stop each cycle to check if the
blockage has been cleared.
If the victim unable to
make any sound at all. Alert!
• Do not thrusts on pregnant and on a very large sized
adult.
DROWNING
Introduction
 Drowning causes asphyxia by water entering the lungs or
by causing the throat to go into spasms so constricting the
air passage (known as dry drowning).
What happens in drowning?
 Drowning is a major source of accidental death and can be
a result of cold, fatigue, injury, disorientation, intoxication
etc. or the victim’s own limited swimming ability.
 The drowning victim struggles to inhale air as long as
possible but eventually he goes beneath the water where
he must exhale air and inhale water.
Effect of drowning
 Airway obstruction
 Asphyxia
 Congestion of lungs
 Injuries to head and neck
 Internal injuries (broken bones, soft
tissue injuries, internal bleeding)
 Hypothermia
Signs and symptoms
General symptoms and
signs of asphyxia.
Froth around the
casualty’s lips, mouth and
nostrils.
Treatment
1. Reaching the victim:
 Pull the patient from the water using rope,
branch, fishing pole, stick, towel, shirt. Lie down
flat on your stomach and extend your hand or leg.
 Throw him an object that will float with line i.e.
tyre, foam cushions, logs, boards, plastic toys.
 Use boat and life jacket, if available.
 Tow the victim to the shore.
Do Not: Swim to the patient.
Cont’d
2. Stabilization of the victim in the water:
 Keeping the victim’s head and body aligned,
place one of your hands in the middle of his/her
back. Your arm directly over the victim’s head.
 Place your other hand under the victim’s upper
arm, near the shoulder.
 Slowly and carefully, rotate the victim over in the
water by lifting the shoulder up and rotating it
over.
 Support the victim in neutral position in water,
start mouth-to-mouth ventilation.
Cont’d
3. Resuscitation:
 Quickly remove any obstructions such as
sea-weed, mud from nose and mouth, start
artificial ventilation immediately. It is
possible to begin ventilation even in water.
 Ifwithin your depth, use one arm to
support the casualty’s body and use the
other hand to support the head and seal
the nose while you perform mouth-to-
mouth ventilation.
Cont’d
 If in deeper water, give the occasional breath of
air while towing the casualty ashore.
 Turn the victim face down with head to one side
and arms stretched beyond his head.
 Use postural drainage to clear water aspiration.
Child:
 Child and infant can be held upside down for a
short period. Raise the middle part of the body
with your hand round the belly. This will cause
water to drain out of lungs.
Cont’d
Adult:
 Raise the middle part of the body as in children. Press the
chest and coastal margin to press the lungs and to
remove water from the lungs.
 Check breathing and heart beat and continue
resuscitation, if necessary.
 As soon as breathing begins, keep casualty in recovery
position.
 Remove wet clothing. Keep the body warm, cover with
blankets. Give hot drinks, coffee and tea.
 Do not allow him to sit up.
 Shift casualty to hospital in recovery position.
Things to remember..
 The chance for survival in warm water is much
less than in cold water. The colder the water, the
better the chance for survival.
 In fresh water drowning, water passes trough the
lungs into the circulation and may cause dilution
of blood. This interferes with oxygen exchange.
 In salt water drowning, salt from the aspirated
water causes the loss of large amounts of fluid
from the circulation into the lungs. This causes
water accumulation in the lungs and death.