Choking in children

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  • Choking in children
An enjoyable reunion of old friends at your home has just ended and you are accompanying them to the door. As you return to the living room a short moment later, you find your 2-year-old son John coughing next to the sofa. Intensity and persistence of the coughing rise. After a while, John becomes exhausted, his skin turns slightly blue and the cough ceases gradually and becomes nonproductive. There's no visible sign of a foreign body present in the oral cavity. What will you do to help John?

I will perform 5 back blows. If that won't lead to any change, I will sit him down leaning slightly forward and let him inhale cold air (from a fridge or a window).

Wrong answer

Inhalation of cold air is indicated in cases of acute laryngitis. This condition is characterised by a slower progression and accompanied by prodromes, subfever, hoarseness and dry cough. According to the signs described above, we would rather be considering an aspiration of a foreign body.


Back

I will perform 5 back blows and 5 chest compressions.

Wrong answer

Chest compressions should be performed in patients under 1 year, whereas abdominal thrusts are contraindicated due to high probability of causing damage to their relatively large liver. Our patient is older now and it is possible to use abdominal thrusts.


Back

I will give the child, sitting and leaning forward, up to 5 back blows and 5 abdominal thrusts.

Correct answer

Following the ERC 2015 guidelines for choking children above the age of 1 year it is recommended to hold the child and perform 5 back blows. If the problem persists, 5 abdominal thrusts should follow. Thrusts serve to increase intrathoracal pressure and thus help evacuate the foreign body from the respiratory airway. The procedure should be repeated until the condition of the patient changes.


Continue

I will perform CPR beginning with 2 initial blows continued by 15 chest compressions. I will reapeat the cycles of 15 chest compressions and two rescue breaths.

Wrong answer

There is no reason to perform CPR in a conscious patient.


Back

 
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