How to react if your baby chokes. Guest Blog by Resuscitation Officer at Top London Hospital.

Facing the unthinkable.. can I do it?  YES you can and there are simple ways to become empowered to do so!

You are in the front room with your child and they begin to cough, your attention is instantly peaked. The cough seems louder than normal, different and you feel a sense of panic and dread come over you.. they are choking on something.  The child has a panicked look on them; they have gone red and now are starting to go blue at the lips… what would you do?  Could you do anything?  The simple answer is YES.

Choking is one of the biggest fears a parent has for their child and yet the recognition and treatment of choking is something that is simple to learn.  Learning basic life support and how to recognise and intervene with choking can be one of the most liberating and empowering life skills anyone can ever learn.

It is often a reason why a parent may undertake a basic life support class, not because they feel their child is in any specific risk of having a heart attack but it is the real worry that their child may choke on something and the parent would feel helpless to do anything about it.

Choking is an every day occurrence for everyone and is often over looked as a coughing fit.  It is this “COUGH” that is key to establishing how serious the situation is or not.

Coughing is used to assess the effectiveness of ones breathing when their airway is potentially compromised or under threat.  In resuscitation terms the cough is referred to as either an “effective cough” or a “non-effective cough”.   The cough is Mother Nature’s way of clearing one’s airway.  Negative pressure within the chest cavity is created using the cough effectively forcing air out of the airway and (hopefully) the foreign body with it.  With this in mind, for older children and adults management of an effective cough is all about encouraging the person affected to keep coughing and nothing more.

When the cough is silent, or all that is heard is a raspy breath either inwards or outwards, rarely together and the person affected is not able to verbalize then we would be looking at dealing with a non-effective cough.  It is with this type of cough that intervention is required and quickly.  This is normally done using the instinctive “back blow” 5 times between the person’s shoulder blades, should this not work an abdominal thrust, which is more commonly known amongst the general public as the “Heimlich Maneuverer” is the next method to forcibly remove a foreign body from ones airway.  These maneuvers are designed for children (over the age of 1) and adults.  For infants, the intervention is different.  Mainly in that encouragement is going to be a futile effort and therefore physical intervention is potentially required sooner rather than later.

Babies often choke when being fed.  The Resuscitation Council (UK) offer this advice regarding feeding, “Do not attempt to feed children who are upset”.  It is this authors opinion that who ever wrote that line has never been within 6 feet of a child!  Infants and children are often upset when being fed for a multitude of different reasons.  The trick here is having a little foresight!

If the child is screaming or crying and you try to force the spoon full of food into an open crying mouth whilst the child’s eyes are shut, they will more than likely be inhaling at this point and will therefore inhale the food from the spoon into their airway causing them to choke.  The resultant actions that follow are panic, guilt and the child being struck on the back numerous times until the parent is happy the airway is clear! 9 times out of 10, this action is enough, but sometimes a more practical measured approach is required and that is where the training from a basic life support class can help to empower you so that in the event that a child in your care develops a non-effective cough YOU CAN DO SOMETHING ABOUT IT!  Back blows and chests thrusts are to be used for infants but to describe them in words can be quite daunting and confusing. With this in mind there are numerous videos available online that show how to do this, also available to you is the Resuscitation Council UK (RCUK) website (www.resus.org) and the European Resuscitation Council (ERC) (www.erc.edu) with free information leaflets and pictographic instructions. However, and this is not a sales pitch (there are many first aid classes available, I just happen to be one of them), nothing replaces guided practice with a manikin and tutor trained and experienced in basic and advanced life support.

It is my thought that any parent can do any of this, and it is my thought that parents should be exactly that, parents. The information above is for guidance and encouragement that in the event of an emergency that YOU can do something, other than panic.

For parents who are concerned about any aspects discussed above the take home messages from this blog post are simple: –

EARLY RECOGNITION SAVES LIVES!
STAY CALM!
YOU CAN DO THIS!

Basic Life Support, is exactly that BASIC, as soon as it becomes complicated that is when people shy away from it and that is not acceptable.

Conflict of interest declaration

Resus Andy/Andy Winter – The author of this blog post is a paediatric emergency nurse currently working at a central London hospital as a Resuscitation Officer he is also an Independent Resuscitation Training Tutor who offers private life support tuition to families and carers.  He is based in London. His website is ResusAndy.com