Choking is a hazard not to be taken lightly as it can occur at any time, giving us little time to react Our throat contains two pathways?the oesophagus (food pipe) and the trachea (windpipe). The trachea leads directly to the lungs and therefore any foreign object lodged in there can result in choking. One may start gagging, coughing, grasping their throat, wheezing or even fainting. In some cases, one may even turn blue, which is known as cyanosis. According to a 2021 paper in the journal National Center for Biotechnology Information, cyanosis occurs when “oxygen might not reach hemoglobin in an adequate or sufficient amount as a result of conditions affecting the respiratory system, cardiovascular system, and the central nervous system”.

 

What starts as a coughing fit can turn into a real emergency if one’s airway is completely blocked. It can prevent oxygen from entering the lungs and cause irreversible damage or even death within minutes. Apart from choking, a person may also stop breathing and lose consciousness due to an accident. Training or at least awareness of first aid maneuvers like Cardiopulmonary resuscitation (CPR) and Heimlich maneuver can help you save a life or at least keep them alive until professional help arrives. Henry Heimlich, the inventor of the Heimlich maneuver, estimated that this move has saved over 50,000 people. On the other hand, the American Heart Association claims that proper CPR training and quick action can save the lives of 100,000-200,000 people annually.

 

Here is a comprehensive introduction to these two first aid methods, although you must remember to follow-up these incidents with a proper medical check-up to check for any retained damage.

 

The A-B-C of first aid maneuvers

After calling an ambulance, the National Health Service, UK, suggests checking the ABC?Airway, Breathing and Circulation?before beginning first aid. Check if they are responsive, conscious and are opening their eyes. You can check if they are breathing normally by noticing the rise and fall of their chest. Gasping, wheezing or pained breathing is not normal. The Indian Red Cross Society, alternatively, suggests measuring the AVPU (alertness, responding to voice, responding to pain stimulus and unresponsiveness). You can assess the severity of the situation and start the following maneuvers immediately.

 

How to help a choking person with the Heimlich maneuver?

Invented by American surgeon and researcher Henry Judah Heimlich in 1974, this move is also known as the abdominal thrust maneuver. The purpose of the move is to push on the diaphragm (a respiratory muscle located below the lungs) and force the person to cough out the foreign object using the reserve of air in their lungs.

1. On self

• If you are able to stand, fold one of your hands into a fist and place it a couple of inches above your belly button.
• Grab your fisted hand with your other hand firmly.
• Thrust your hands inwards and slightly upwards, so as to push up on your diaphragm.
• Repeat around five times, until you can cough or breathe normally.
   

2. On an adult or child over one year

• Stand behind the person.
• Make them lean slightly forwards and slap their back around five times.
• If this doesn’t work, put your arms around their waist from behind and grab your fisted hand with the other.
• Thrust inwards and upwards to push the air in your lungs towards the trachea.
• Repeat these sharp thrusts five times.
   

Precautions: Though this maneuver can be performed without any prior training, it is important to do it as safely as possible. According to a 2021 paper in StatPearls Publishing, for pregnant individuals, the thrusts should be placed a little above the abdomen and towards the breastbone. It is also important the Heimlich technique is only recommended for conscious adults, while backslaps are better suited for infants and chest compressions for the unconscious. The Heimlich is not a solution for drowning or asthma.

Source: National Health Service (UK), University of Florida Health (US)

 

 

When and how to perform CPR?

According to the Indian Red Cross Society, Cardiopulmonary resuscitation or CPR is an attempt to revive an unconscious or unresponsive person’s blood and oxygen circulation in the heart and the brain through chest compressions, rescue breathing or a combination of both. CPR is a little more complicated than the Heimlich maneuver, hence, training is highly recommended. If you are untrained, call a professional first and stick to compressions only.

 

 

1. On an adult or child over one year

• Place your hands on top of each other over the subject’s chest.
• Administer 2 inch deep compressions at the rate of 100-120 compressions per minute. In the case of adults, make sure to use your full bodyweight.
• To better explain the 100-120 compressions per minute rhythm, First Response Training International recommends aligning your pushes to the rhythm of the song “Stayin’ Alive” by Bee Gees as well as other songs that have 100-120 beats per minute.
• If they are still unresponsive, deliver 2 rescue breaths by lifting their chin to straighten their neck. Pinch their nose shut and blow into their mouth.
• Make sure their chest rises between each breath or compression.
• Continue this combination until you see some response from the subject, a foreign object that needs to be removed, ejection of retained water in lungs or medical help is available.
• Refrain from first aid if you yourself are injured, unsafe or exhausted as it may worsen the situation for both of you.

 

 

2. On an infant below one year

• If a baby is choking, you can begin by resting the baby on your leg, leaning them forward on your arm and slapping their backs gently five times to eject the object.
• If the baby is unresponsive and not breathing, begin CPR by performing 2 rescue breaths by lifting their chin, pinching their nose and exhaling directly into their mouth. Make sure no air escapes.
• In case this too fails, you can move on to chest compressions. Place two fingers to deliver 30 quick compressions over their heart about 1.5 inches deep. Make sure you don’t use your full body weight as it can cause rib injury.
• Continue CPR until the baby revives or professional help arrives.

 

3. On a pet

• Begin chest compressions if the pet has no heartbeat or chest movement.
• Place one hand on top of their heart and the other directly over the first hand.
• Make sure your elbows are locked and your shoulders are placed right above your hands.
• Push hard at the rate of 100-120 compressions per minute for about ½ to ? of the depth of the animal’s chest.
• Their chest must fully recoil before you compress again.
• Repeat for 30 full compressions.
• If they don’t respond, give two rescue breaths by extending their necks, closing their mouths and exhaling into their nose until their chest rises.
• Continue this combination of CPR for a couple of minutes and then check their breathing until you reach veterinary help.

 

Precautions: While the hands-only compression can be performed by most, it is better to do so with proper know-how to ensure maximum safety and effectiveness. If you establish contact with an emergency responder or a hospital, you can also ask them to guide you through the process.

Source: American Red Cross, Indian Red Cross Society, American Heart Association