From: ted@zeus.ocs.com (Ted Scott)
Subject: Re: Choking - What to do?
Organization: Online Computer Systems, Inc.  Germantown, Md., 20874
X-Newsreader: Tin 1.1 PL4
Date: Thu, 20 Aug 1992 14:25:32 GMT

Had to respond to this one, it's a little long ...

smergen@luna.dpl.scg.hac.com (Sandra Mergen) writes:
: After having 2 children, you'd think that I was an old pro
: at this but I always still panic when something gets caught
: in my children's mouth/throat.

Prefectly natural!

: Instinct made me slap her back and luckily it came up to 
: her lips where I could grab it.

Yes, that's the first step, the back slap. The "finger sweep"
should NEVER be done unless you can see the object, the danger 
being what you described. An additional complication is that 
children have a gag reflex that is triggered much more easily 
than adults and is more intense. (so are other infant reflexes
i.e. startle etc)

: But, in the baby books, I read that you put the baby over
: you knees and push on their chest in between the ribs, to
: get the foreign object to come back up.

I don't know where you mean by "in between the ribs".

: Do you do this only when you cant get the object out by
: either fishing it out or by slapping their back?  My
: pediatrician also mentioned the pushing the chest method.
: I don't see how it could work.  Has anyone had to try it?

PLEASE take a CPR course. Treatment for choking of all ages
is taught in both ciriculums (ciriculi?) offered by the
AMR (American Red Cross) and the AHA (American Heart 
Association). I'm unsure of who teaches or defines course
content outside the states. The choking protocol is:

1.      Identify choking. Adults will typically grasp thier 
        throat, and make funny noises. Infants just make 
        funny noises. This is the time to take a couple
        of deep breaths and calm yourself.

2.      Determine wether or not air is being exchanged. If
        the person is making wheezing noises, air is being 
        exchanged.

3.      If air IS being exchanged, ask if they want help,
        provide back slaps, encouragement, help them cough
        or move if they want. Be prepared to catch them
        and guide them safely to the floor if the airway 
        becomes blocked, or they faint.

4.      If air IS NOT being exchanged, ask if they want help.
        (haven't had a refusal yet :-) Call for help, yell,
        have someone call the ambulance. Perform the Hiemlic
        manuver (for adults and larger Kids ~100lbs &^). 
        This is a SHARP thrust inward and upward from a point 
        midway between the navel and the zyphoid process 
        (the tip of the sternum). This thrust may be 
        accomplished by standing behind the person and 
        making a fist, put your arms around place your fist
        above the navel and grab the fist with your other 
        hand. Thrust 7 to 10 times. Be prepared to help them
        to the floor if they pass out. Be prepared to manage
        vomiting. On the floor stradle the legs and use the 
        heel of your hand. In between groups of thrusts, 
        check the mouth for the object.
        
        For Infants (0 to 2 y.o.) you should use a chest 
        thrust. I prefer to place the infant in a "football"
        carry on my left forearm (legs to elbow, head in palm),
        rather than accross my knees This allows me to move 
        while performing the manuver, and better manage the 
        airway. Place two fingers on the vertical midline on 
        the chest (over the sternum) on a line between the 
        nipples:
                      neck
                        |
          nipples->  o--+--o   Place fingers over   +
                        |               
                        |
                        o
                      navel  
        
        Thrust your fingers sharply to depress 1 - 1/2 in.
        and follow the rest of the adult protocol.

        In either case if the object becomes partially 
        dislodged and air is being exchanged, go back
        to the air is being exchanged step, provide
        support, and wait for the ambulance.

Again, Please take a CPR course! Choking and heart attacks
are serious problems that cannot be adequately explained 
on paper. You will hear crunching during CPR, and the courses 
have practice manequins that provide you with a feel of how 
hard you should be pushing. Contact the Red Cross, AHA, or 
your local Fire Department, Police station to find courses.
They are also often organized by church groups and other 
organizations.

--

-Ted Scott          
tscott@ocsmd.ocs.com           I was told that I'm a P.C. person:
(301) 601-2252                               Politically Challenged, that is.
Newsgroups: misc.kids