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Choking is a Key Injury to Minors and Children

Children are susceptible to choking because they often place small objects in their mouths. When these objects are swallowed, they can become lodged in the throat or windpipe, which blocks the flow of air. Choking cuts off oxygen to the brain, which makes it an emergency. Choking can lead to brain injury if the brain is depleted of oxygen long enough and it can also lead to death.

Most people who are choking will clutch their throat. Other signs of choking include:

1) Difficulty breathing or noisy breathing.
2) Inability to speak or cough.
3) Loss of consciousness.
4) Change of color of the skin, lips and nails. In someone who is choking, the skin, lips and nails may turn blue or dusky.

If someone is choking, perform the Heimlich maneuver to get the foreign object out of the victim’s windpipe or throat. If there is more than one person present, have one person call the emergency number on your area (or 911) while the other person performs the Heimlich maneuver. If you are the only person present, perform the Heimlich maneuver first and then call for help.

To perform the Heimlich maneuver:

1) Stand behind the victim who is choking. Place your arms around his or her waist. Gently tip the victim forward a little.
2) Make a fist and place the fist just a little above the person’s navel.
3) Take the fist into your other hand. Press hard into the victim’s abdomen. Use a quick, upward thrust to do this. It may help to pretend that you are using the same gesture you might use if you were trying to lift the victim up.
4) Repeat the upward thrust motion until the object in the mouth is dislodged. You will usually be able to tell because the object may expel from the victim’s mouth with some force.
5) Keep the victim calm and get them checked out by a doctor, if necessary.

If you are alone and you begin to choke, you may not be able to rely on anyone else to help you. In this situation, you will have to perform the Heimlich maneuver on yourself. To do this:

1) Ball one hand into a fist and place the fist somewhat above your navel.
2) Grasp your fist with your other hand. Bend over a hard surface such as a chair or table.
3) Push your fist into your abdomen with a hard inward and upward motion. Repeat until the object becomes dislodged from your throat.

If you are trying to help a choking victim who is obese or pregnant, you will need to position your hands a little bit higher than with a usual Heimlich maneuver. Position your hands at the base of the breastbone. This should place your hands just above the joining of the lowest rib. You will use the same upward motion, but you will be pressing into the chest, using hard, quick thrusts.

If you are not able to help in time or if the first attempts at the Heimlich maneuver do not work, the choking victim may become unconscious due to lack of oxygen. You can continue to perform the Heimlich maneuver on an unconscious person. To do this:

1) Gently place the victim on his or her back on the floor.
2) Open the person’s mouth and look to see if you can see visible blockage at the back of the throat or high in the throat. If you can see something, reach a finger into the mouth and remove the blockage. When doing this, be very careful not to push any blockage deeper into the throat.
3) If this does not help, begin CPR (cardiopulmonary resuscitation). The chest compressions you must use in order to perform CPR can dislodge the obstruction. Keep checking to see whether the blockage is visible in the throat. If it becomes visible, try to remove it with your hands, as explained in steps 1 and 2.

If an infant younger than age 1 is choking, you cannot perform the Heimlich maneuver as for an adult, since the pressure can cause fractured ribs. To perform the Heimlich maneuver on an infant, you must:

1) Sit down and rest your forearm on your thigh. Hold the victim face down on your forearm.
2) Using a gentle but firm motion, thump or tap the victim five times on the middle of the back. Use the heel of your hand to do this. The idea is to use both gravity and the thumps to dislodge the item.
3) If the victim is choking, hold the victim face up on your forearm. Make sure that the head is lower than the chest. Place two fingers at the center of the victim’s breastbone, and give five quick, firm, and gentle chest compressions.
4) If the victim is still choking, repeat the back thumps and the chest compressions again. Call 911.

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