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CPR PROCEDURES

Choking
can result in unconsciousness and cardiopulmonary arrest. It is often caused by food or other foreign body lodged in the throat (airway). Indeed, choking caused by foreign-body airway obstruction accounts for about 3,000 deaths each year. Recognition and proper management of choking is of key importance to safety at home and in restaurants and other public places. (Other conditions that may cause unconsciousness or airway obstruction but are managed differently include stroke, epilepsy, swelling due to infection, head injury, intoxication, overdose, coma of any cause, and heart arrest.)

Prevention
is no accident Adults

Cut food into small pieces. Chew food slowly and thoroughly, especially if you are wearing dentures. Avoid laughing and talking while chewing and swallowing. Avoid excessive intake of alcohol before and during meals.

Infants and Children

Keep marbles, beads, thumbtacks, and other small objects out of their reach and prevent them from walking, running, or playing when they have food or toys in their mouth.

Procedure for Adult Choking Victim

Conscious Victim

1. Ask, Are you choking? If the victim can speak, cough, or breathe, do not interfere.

If the victim cannot speak, cough, or breathe, give abdominal thrusts (the Heimlich maneuver) until the foreign object is expelled or the victim becomes unconscious.

(In case of extreme obesity or advanced pregnancy, give chest thrusts.) 3. Be persistent. Continue uninterrupted until the obstruction is relieved or advanced life support is available. In either case the victim should be examined by a physician as soon as possible. 4. Activate the EMS system. 5. Perform a tongue-jaw lift followed by a finger sweep to try to remove the foreign object.

6. Open the airway and try to give 2 slow rescue breaths. If unsuccessful, reposition the head and try again.

7. If unsuccessful, give up to 5 abdominal thrusts (the Heimlich maneuver).

8. Repeat steps 5 through 7 until effective. If the victim resumes effective breathing, place in the recovery position. 9. After the obstruction is removed, begin the ABCs of CPR if necessary:

Airway open the airway Breathing if still no breaths, attempt rescue


breathing

Circulation if no pulse, perform chest


compressions 10. Be persistent. Continue uninterrupted until the obstruction is relieved or advanced life support is available. When successful, have the victim examined by a physician as soon as possible.

Procedure for Infant and Child


When there are signs of choking in an infant or child:

If
the infant or child is breathing and continues to be able to speak or cough,

Then
do not interfere but take to an advanced life support facility.

If
the infant or child has a fever and a history of illness (the air passages may be swollen),

Then
transport immediately to an emergency care facility.

If
the infant or child has ineffective coughing and high-pitched inspirations and is unable to speak

Then
immediately begin the obstructed airway sequence described below.

or cry,

Conscious Infant (younger than 1 year)

Up to 5 back blows and 5 chest thrusts

To dislodge an object in the airway of an infant: 1. Support the infant's head and neck with one hand firmly holding the jaw. Place the infant face down on your forearm, keeping the head lower than the trunk. 2. With the heel of your free hand, deliver up to 5 back blows forcefully between the infant's shoulder blades.

3. Supporting the head, sandwich the infant between your hands and arms and turn the infant on his or her back, keeping the head lower than the trunk. Using two fingers, deliver up to 5 thrusts over the lower half of the breastbone (sternum).

4. Repeat the sequence of 5 back blows and 5 chest thrusts until the object is expelled or until the infant becomes unconscious. Finger position for chest thrusts. Depress the sternum 1/2 to 1 inch for each thrust. Avoid the tip of the sternum. Alternate method: Lay the infant face down on your lap, with the head lower than the trunk and the head firmly supported. Give up to 5 back blows. Then turn the infant as a unit to the supine position and give up to 5 chest thrusts.

Unconscious Infant

1. Call for help. If someone comes, that person should activate the EMS system.

2. Open the airway (head tiltchin lift) and try to give 2 slow rescue breaths. If the airway is still obstructed, reposition the head and try again to give rescue breaths. 3. Give up to 5 back blows, then up to 5 chest thrusts. 4. Perform a tongue-jaw lift, and if you see the obstructing object, perform a finger sweep to remove it. 5. If the foreign body is not removed, repeat steps 2 through 4 until successful. If the infant resumes effective breathing, place in the recovery position. 6. If airway obstruction is not relieved after about 1 minute, activate the EMS system. 7. If the foreign body is removed and the victim is not breathing, begin the ABCs of CPR:

Airway open the airway Breathing if still no breaths, attempt rescue


breathing

Circulation if no pulse, perform chest


compressions If victim is still not breathing after about 1 minute and EMS has not been activated, activate now.

8. When successful, have victim examined by a physician as soon as possible.

Conscious Child (1 to 8 years)

To dislodge object from the of a child:

an airway

Perform the Heimlich maneuver as described for

adults.

Unconscious child

If the child becomes unconscious:

Continue as for an adult, except

Do not perform blind finger sweep in children up to 8 years old. Instead, perform a tongue-jaw lift and try to remove the foreign body only if you see it.

Note: Abdominal thrusts are not recommended in infants. Blind finger sweeps should not be performed on infants or small children.

For a

Healthier Heart

Have your blood pressure checked regularly. Do not smoke cigarettes. Eat foods low in saturated (animal) fats and cholesterol. Maintain proper weight. Exercise regularly. Have regular medical checkups.

Emergency
Emergency Medical Services (EMS) System
When you begin first aid for choking or cardiopulmonary resuscitation, you must consider the victim to need advanced life support. He or she will have the best chance of surviving if your community has an Emergency Medical Services system. This system includes an efficient communications-alert system, such as telephone #911, of which the public is well aware; well-trained rescue personnel who can respond rapidly; properly equipped vehicles; an emergency facility that is open 24 hours a day to provide advanced life support; and an intensive care section in the hospital. You should work with all interested agencies to achieve such a system.