Child CPR & Choking

Because they have smaller windpipes, children can easily choke on small objects or big bites of food. Even food that seems small enough for them to chew and swallow can be a choking hazard, so it's important that parents and caretakers know how to swiftly react and perform the appropriate first aid for the given situation.

Signs of Conscious Choking

• Most people know that the universal sign of choking is two hands crossed at the throat. Unfortunately, children don't necessarily know or follow telltale indications. Further signs of choking include raspy or noisy breathing, the inability to talk or even utter a single word, the inability to inhale enough to make a forceful cough or to cough at all, and the appearance of blue fingernails, lips or skin.

Choking First Aid for a Child

• Choking first aid for a child aged one to eight is the same as for adults. The first step is to ask him if he's choking---as long as the he's old enough to understand. If the child can respond, five back blows may be enough to help him dislodge the object from his throat. Back blows are administered with the heel of the hand to the space between the shoulder blades. If the object doesn't dislodge, the five back blows are followed by five abdominal thrusts. A caregiver administers abdominal thrusts by standing behind the child, wrapping her arms around him with one hand in the shape of a fist---tucked thumb placed just above his navel---and using the other hand to thrust her fist into his abdomen in an upward direction. As long as the child remains conscious, the five-to-five cycle is repeated.

Unconsciousness

• If choking reaches the point where a child can no longer breathe at all, immediate action is crucial. If more back blows and abdominal thrusts don't finally dislodge the object, the child will lose consciousness. An unconscious child should be laid on his back, chin tilted upward and mouth open. The caregiver should look for the object in his throat. If one is visible, the she must perform a finger sweep to clear it out---being careful not to push it further into his throat. If the object doesn't come out, or, if it does but the child has no pulse and isn't breathing, CPR is the next step.

Child CPR

• The Mayo Clinic states that a caregiver begins CPR "if the object remains lodged and the [child] doesn't respond.... The [CPR] chest compressions... may dislodge the object." Child CPR is begun by tilting the head back, opening the mouth, pinching the nose closed and giving two breaths. The caregiver's mouth should form a seal around the child's so her air goes in directly, making his chest rise. If the blockage remains, his chest may not rise. The caregiver then administers thirty quick chest compressions by crossing one hand over the other and pushing the heel of the bottom hand into the child's sternum. During CPR on a choking victim, it's important to re-inspect the mouth for the object.

Considerations

• If a child is able to cough or talk but is still choking, encouraging him to cough is important; most choking children are able to dislodge the object on their own. For a caregiver who is alone with a choking child, it's more important to administer first aid before calling 911. If there are others on the scene, someone else should call for emergency help while aid is being continuously given.