SYMPTOMS: Your 2-year-old is eating peanuts and running
around. Suddenly, he starts coughing violently. There is a
strong possibility that he has inhaled the peanut into his
windpipe, resulting in obstruction to the free flow of air. Do
not panic. Coughing might help in expelling the peanut.
Sometimes, if the obstruction is more severe, due to a
foreign object or food, he may not be able to talk normally and
may turn blue. Treat this as an emergency and act quickly as
detailed below. Sometimes, a little water or milk or soup or any
other liquid tends to go into the windpipe and the child coughs
to stop that or to expel the little liquid that might have gone
into the windpipe. This need not be a cause of worry.
MANAGEMENT: Emergency steps to be followed:
Step 1: If your small infant has difficulty in breathing
and is becoming blue, shout for help. Lay him in a head-down
position on your forearm. Let your arm rest on your tilted thigh
with his head just below your knee. Then give 4 rapid blows on
his back with the heel of your other hand between the 2 shoulder
blades (see illustration). It may be
inconvenient to rest an older infant on the arm. Lay him face
down on your lap, with his head towards the ground and supported
with one hand.
Step 2: If you find no improvement, put him on the floor on
his back. Using 2 or 3 fingers, give 4 rapid chest thrusts over
the breastbone lying in the centre of the chest.
Step 3: If you can now see the foreign object or food in
the childís mouth and feel confident that you can easily
remove it, pluck it out with your finger.
Step 4: If the child is not breathing, follow step 3 with
mouth-to-mouth breathing (see Cardiac Pulmonary Resuscitation
and Mouth-To-Mouth Breathing).
Step 5: Keep repeating steps 1 to 4 till the child improves
or you get some medical help.
Helping An Older Child With Choking
Stand behind the child and wrap your arms around his waist.
Make a fist with one hand and grasp it with other hand. Put your
fisted hand on the upper abdomen just below the breastbone of
his chest. Then press into his abdomen with a sudden springy
upward jerk. You may have to do this repeatedly (upto a dozen
times) for him to bring up the foreign object (see
illustration). As before, mouth-to-mouth breathing may be
required if the child is not breathing.
The Heimlich Manoeuvre
It is now thought that the Heimlich Manoeuvre is too
difficult for most people to perform on an unconscious person.
The new guidelines say that chest compressions provide the same
effect as the Heimlich abdominal thrusts. Itís also no longer
necessary to do a finger sweep of the victimís mouth to clear
airway obstructions. Chest compressions alone should be enough
to expel anything lodged in the airway.
7 March, 2016