Choking

We have all experienced at one time or another the choking sensation of food having "gone down the wrong way".

It’s an uncomfortable feeling and one that we are unlikely ever to forget. It happens when food, or some other material, goes into the windpipe instead of the gullet.

It’s a frightening thing to have happen to oneself and it can be just as frightening seeing it happen to someone else. The important thing is not to panic.

The condition often looks worse than it actually is, so don’t start out by poking your fingers down someone’s throat to see if you can dislodge whatever it is that’s causing the blockage.

Nor should you attempt any of those strange maneuvers, such as the Heimlich, which have been popularized by various magazines. They are dangerous. Do not use them. Even slapping someone on the back who is choking is to be avoided, since the likely outcome is that it will make the condition worse.

The plain fact is that for as long as the victim is breathing and is able to cough, the only thing you should do is reassure them.

However once it becomes apparent that the blockage is more or less permanent (indicated by persistent wheezing and breathing difficulties)– you should immediately send for medical assistance.

The time for action on your part is ONLY if the victim stops breathing altogether.

If this happens, and you are dealing with an adult, help them to lie on the floor on one side and strike them firmly between the shoulder blades with the heel of your hand. Do this up to four times.

If this fails to work place your hands on the side of the rib cage, keeping the patient in the same position, and thrust downwards three or four times. Then check to see if the object has been dislodged.

If the victim is still unable to breathe, they are likely to become unconscious very quickly. If this happens keep them in the same position and try to clear the airway. In particular, look in the mouth for any visible material which may come loose as their muscles relax through loss of consciousness.

Tilt the head back and support the jaw to open the airway as much as possible.

If, after all this, the victim is still not breathing you must perform mouth to mouth resuscitation until the ambulance arrives.

Even if you have never done it before, this is the time when you have to try. If you don’t, the victim is likely to suffer brain damage and may even die.

Roll the victim onto their back, tilt the head back to open the airway, pull the jaw down, pinch the nose and breathe into the patient's mouth. You will have to do this quite forcefully because of the obstruction. In fact, you may even dislodge it, forcing it into the lungs.

Do not worry about this, it can be removed later. The important thing is to get air into the lungs as quickly as possible.

Alternate your resuscitation attempts with further back blows and rib squeezes.

Children

In the case of a child, get them to lie face down over your knees rather than on the floor and carry out the same procedure, except that you should give back slaps rather than back blows.

Also, rather than thrusting down on the ribs, squeeze them with a hand on either side of the body.

Be assured that although choking is a very dramatic event, and often frightening for both patient and helper, it is a rare cause of death.

Simply carry out the above procedures calmly and quickly and, as always, send for assistance.