Choking in Children

In the blink of an eye, a child can put a foreign body in their mouth. Suddenly they are choking or gasping for breath. Any piece of food, candy, toy or small household item may suddenly become a threat to your child's life. It is impossible to foresee all things that may become a threat to your child; however there are some accidents you may prevent.

FOLLOW THESE COMMON SENSE GUIDELINES:

  • Cut food into small pieces and tell your child to chew their food thoroughly.

  • Remove small bones from meat, fish, and poultry.

  • Remove large seeds from fruit.

  • Do not allow babies to eat on their back.

  • Keep safety pins off the changing table.

  • Remove loose toy parts, throwing away broken pieces.

  • Supervise children when they play with balloons.

  • Make absolutely sure any small disc batteries are kept away from children. When these are swallowed, they become a medical emergency. When ingested, these will erode through the gastrointestinal tract within a very short period of time and can rapidly cause problems which may result in death.

  • Attend CPR training (includes choking, rescue breathing and CPR for infant, child and adult).

If the choking victim is still breathing and has a forceful cough, strong cry or is able to speak or make some sounds, do not interfere. Allow him/her to clear the airway with coughing. Stay with him/her and watch closely for signs of severe airway blockage.

Signs of a severe airway blockage include:

  • The cough becomes weak, ineffective or silent.

  • Soft or high-pitched sounds while breathing.

  • Inability to cry, speak or make sounds.

Immediate action is needed if the choking victim has signs of a severe airway blockage.

With severe airway blockage, prepare to do 1 of the following:

  • For a conscious child over the age of 1 year:

  • Stand or kneel behind the choking victim and wrap your arms around the victim's waist. Have the victim lean forward slightly and tilt the head down.

  • Make a fist with 1 hand. Place the thumb of the fist slightly above the victim's belly button and below the breastbone.

  • Grasp the fist with the other hand.

  • Do repeated, quick upward abdominal thrusts with your hands to try to force the object out of the airway. Do this until the object comes out or the victim becomes unresponsive.

  • For an conscious infant under the age of 1 year:

  • Place the choking infant face down on your arm. Hold the infant's chest with that hand and support the jaw with your fingers. Place the infant's head lower than his/her body. Use your thigh to support the infant.

  • Give up to 5 quick, forceful back blows (slaps) between the shoulder blades with the heel of your other hand.

  • If the object does not come out after the back blows, turn the infant face up on your forearm. Support the infant's head with that hand. Use your thighs to support the infant.

  • Place 2 or 3 fingers of your other hand just below a line between the nipples. Give up to 5 chest thrusts down, depressing 1/3 to 1/2 the depth of the chest.

  • Continue the 5 back blows and 5 chest thrusts until the object pops out or the child becomes unresponsive.

  • Do not do abdominal thrusts as they can cause internal injury to an infant.

Do not give the infant or child anything to drink until the airway is clear.

If repeated attempts to remove the object fail, call emergency services (911 in the U.S.) immediately.

A complete blockage will cause the choking victim to pass out. If this happens, call emergency services (911 in the U.S.) immediately and start CPR.

It is always good to be trained to know how to perform the Heimlich maneuver and CPR. All children who have had a serious choking episode should have a medical evaluation and appropriate follow-up immediately after breathing is back to normal.