Chocking
Uploaded by
tanyaChocking
Uploaded by
tanyaChoking
Choking is a medical
emergency that requires
immediate and effective
interference.
• Blockage of upper airway which prevents
normal breathing.
• It causes simple cough but complete
obstruction leads to death
Causes of Chocking:
• Most often food that is not chewed
properly.
• Toys in children.
Risk Factors:
• In adults:
• Advancing age,
• Poorly fitting false tooth,
• Alcohol consumption.
Risk factors
▶Inchildren: usually occurs in kids
area, where children play and run
while holding toys and eating.
• Incomplete chewing of food.
• Hard candy.
• Small objects lodged in the
throat.
Cyanosis: blue color
Turning Blue, Known as “CYANOSIS”
• When the airway is completely blocked,
• No oxygen can enter the lungs,
• So the chocked person turns blue.
• Early seen around the lips, in the face, then fingernail
beds.
Symptoms and signs of choking
▶Adults:
• Coughing or gagging.
• Hand signals and Panic.
• Pointing at throat.
• Sudden inability to talk.
• Wheezing.
• Passing out.
Symptoms and signs of choking
▶Children:
▶PAY MORE ATTENTION
• Difficulty in breathing.
• Weak cough, weak cry or both.
Universal Sign of choking
▶Adults:
• Clutching the throat
with one or both
hands.
Management of Choking
▶ Approach with safety
▶Approach gently,
• Assure victim, or the guardian in case of
a child, that you can help
• Encourage victim to cough
▶When cough becomes weak and
ineffective
▶Then,
Start 5 back blows:
• Stand to the side and just
behind a choking adult.
• Place one arm across the
person's chest for support.
• Bend the person over at the
waist so that the upper body is
parallel with the ground.
https://images.app.goo.gl/
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▶ Deliver five separate back blows between the
person's shoulder blades with the heel of your
hand.
▶ Then:
▶Give 5 abdominal thrusts (Heimlich
maneuver)
• Stand behind the person.
• Place one foot slightly in front of the
other for balance.
• Wrap your arms around the waist.
• Tip the person forward slightly. If a
child is choking, kneel down behind
the child. https://
images.app.goo.gl/d
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Abdominal Thrust
• Make a fist with one hand.
• Position it slightly above
the person's navel.
• Grasp the fist with the
other hand.
• Press hard into the abdomen
with a quick, upward thrust
— as if trying to lift the
person up.
▶Alternate between 5 blows and 5
thrusts until the blockage is dislodged.
One vs Two or more
rescuer
If you are alone:
• Start back bows and abdominal
thrust.
If there is more than one rescuer:
Call for
HELP
12
If the victim becomes unconscious:
• Call 123,
• Then start CPR:
• Chest compression 100-120/min.
• Give 2 rescue breaths
every 30 compressions
If the victim is an infant, up to ONE year old
▶Do Not Do Heimlich’s Maneuver
▶NO ABDOMINAL THRUST FOR BABY
BELOW 1 YEAR
Foreign Body removal
▶Do NOT try ever to remove the
foreign body blindly with your finger.
▶Blind finger sweep may lead to
trauma or foreign body impact
Take home message
▶ Chocking is a medical emergency.
▶ Cyanosis is a blue discoloration.
▶ Heimlich maneuver is only indicated
in adults.
Objectives:
• Why it is important to learn how to
open airway?
• How to open airway in unconscious patient
safely and effectively.
• How to apply oropharyngeal, Guedel’
airway.
• Oxygen supplementation.
Why open airway?
• You treat FIRST what kills FIRST.
• Very simple maneuver, yet can save life.
Airway
• Safe: when the patient is conscious and can talk
normally.
• At risk: with partial loss of consciousness or partial
obstruction of upper airway.
• Obstructed: with loss of consciousness or obstruction
of upper airway
Causes of loss of consciousness
• Medical:
• Low blood pressure.
• Low blood glucose.
• Drug overdose.
• Alcohol poisoning.
• Seizure, stroke.
Causes of loss of consciousness
• Trauma:
• Car accident.
• drowning.
• Trauma to the head.
How to open airway
Head tilt-Chin lift
• Tilt the patient’s head back by pushing down on
the forehead.
• Place the tips of your index and middle fingers
under the chin and pull up on the mandible (not
on the soft tissues).
• This lifts the tongue away from the posterior
pharynx and improves airway patency.
Jaw thrust
• Stand at the head of the stretcher and
place your palms on the patient’s temples
and your fingers under the mandibular
rami.
• Lift the mandible upward with your fingers,
at least until the lower incisors are higher
than the upper incisors.
• This maneuver lifts the tongue along with
the mandible, thus relieving upper airway
obstruction.
Be sure to pull up only on the bony parts of the
mandible. Pressure to the soft tissues of the neck
may obstruct the airway.
Remarks
• Head tilt/chin lift is the universal maneuver to open
airway.
• Jaw thrust is used when trauma to the neck is
suspected, e.g. drowning, car accident, falling from
height, etc.
• Avoid extending the neck if cervical spine injury is
possible.
Oropharyngeal airway
Guedel’ airway
▶ Oropharyngeal airways are rigid
intraoral devices that conform to
the tongue and displace it away
from the posterior pharyngeal wall,
thereby restoring pharyngeal airway
patency.
▶ The goal is to relieve upper airway obstruction caused
by a relaxed tongue lying on the posterior pharyngeal
wall.
Contraindication of Oropharyngeal airway
• Consciousness,
• Semiconscious,
• or presence of a gag reflex
Insertion of Oropharyngeal airway
• Sizing:
▶ Use the device
itself.
▶ 1) Measure from
angle of the mouth
to the lobule of the
ear
• Sizing:
▶ OR
▶ 2) Measure
from the central
incisor to the
angle of the
mandible.
• Insertion:
• Introduce the
airway with
the concave
side up.
• Then rotate
180⚬
Oxygen Therapy
Oxygen:
▶21% ofair is oxygen.
▶Oxygen is supplied in cylinders for
medical use.
Who needs oxygen supplementation?
• Patients with lung diseases.
• Patients with heart diseases.
• trauma.
How to know?
▶ Ifoxygen saturation by pulse oximeter is
less than 95% on air.
How to know?
▶ Ifthe doctor takes sample from artery to
analyze the contents of gases. This test is
called Arterial Blood Gas, ABG, analysis.
Symptoms of low oxygen, Hypoxia.
▶ Low oxygen is called hypoxia.
• rapid breathing
• shortness of breath
• fast heart rate
• coughing or wheezing
• sweating
• confusion
• changes in the color of your skin
Simple face mask
• Single patient use.
• Low-flow masks which
entrain the air from the
atmosphere.
• Able to deliver oxygen
percentage from 21-
60%.
• The actual amount of
oxygen the patient
receives will depend on
the rate and depth of
respiration.
• The oxygen mask is
placed over the
patient's nose and
mouth with the elastic
strap over the ears to
the back of the head.
• Adjust the length of
the strap to ensure
the mask fits securely.
Face mask with reservoir
bag
▶ It consists of a face mask
connected to a reservoir
bag that’s filled with a
high concentration of
oxygen.
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• The mask is connected to a plastic reservoir bag filled
with a high concentration of oxygen.
• The mask has a one-way valve system that prevents
exhaled oxygen from mixing with the oxygen in the
reservoir bag.
▶ The mask covers both
your nose and mouth.
One-way valves prevent
exhaled air from
reentering the oxygen
reservoir.
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Nasal
Cannula
▶ A nasal cannula is a small,
flexible tube that contains two
open prongs intended to sit just
inside patient’s nostrils.
▶ The tubing attaches to an
oxygen source and delivers a
steady stream of medical-grade
oxygen to your nose.
▶ Nasal cannulas don't prohibit regular eating and talking,
and they are pretty portable. (Advantage)
▶ The oxygen concentration used with nasal cannulas is
relatively low. (disadvantage)
For the high concentration of oxygen
delivery:
• Nasal cannula is the least,
• Then simple face mask,
• Then face mask with reservoir bag.
