Lucy Piper: Hello, I'm Lucy Piper. It's very likely that at some point you will have to deal with your child choking which can be very frightening. So, what should you do? Paul Sheehan from St. John Ambulance is here to tell us what to do.
Now I know Palvi, you had a bit of problems with him chocking. Tell us about that.
Palvi Karia: I did. He was about 7 months and he was just coming off pulped food into just like little coarser food and because he wasn't ready to chew, he swallowed it and it got stuck in his throat. I was absolutely terrified. He started to gag. He actually went blue and he was panicking himself which made me panic.
Lucy Piper: What did you do?
Palvi Karia: The thing was to get him out of the high chair fast enough, because he was strapped and I got him out fast, slapped him on the back and I put my fingers and then tried to scoop it out, which made him eventually -- he vomited out. I don't know if it was the right thing to do, but that's exactly what I did.
Lucy Piper: Was that the right thing to do?
Paul Sheehan: Yeah! I mean usually in first time situation we follow a rule, I mean, you have done the right thing. First of all, we always look for the danger, because obviously if we just go rushing forward you could end up tripping and folding, toys on the floor and that type of things. So, just make sure that it's safe way to approach. And once you have got close, I would say, you realize that he was chocking. The first thing that we try to do is clear the mouth. If we can see anything, if there's a lolly for example, we pull that out.
If there's anything inside the mouth we hook it, we take it out. Once you try to clear the mouth, and if that doesn't work, one thing that people will always try to do, youngsters as well, is actually trying to cough.
So, if we encourage the person to cough it may actually loosen the objects and it will fall forward and then we can clear it again from the mouth. Failing that, as you then went on, so you did the back slaps.
Now there is a method for doing the back slap. It's kind of -- it's really hard to do it when you -- it's actually easier if you stand, somebody up, that you have to do back slaps on them. So, what you need to do is position yourself behind them. Put one hand onto your shoulder, because that way when you hit them, they don't fall over, possibly if they would. But you put your hand on the shoulder, lean them forward so that their face goes towards the floor and gravity helps, if it moves forward they can spit it out.
If you then, keeping hold, five back slaps depending upon the size and the age of the child. They are going to have to be fairly firm. And what you're going to be doing is you're actually sending the vibration through the body eventually which helps to loosen the object. Inside the lungs pushed together, which forces the air up. And the air hits the object, and then it pushes it forward and then they can spit it out.
You can hit them on the back up to five times. If the five back slaps don't work then you can go onto what we call either the chest or sort of the abdominal thrust, but this depends on the age of the child.
Palvi Karia: I've also got 14 month old baby and would I treat babies the same as toddlers or --
Paul Sheehan: Yeah, we distinguish between babies and toddlers by their age. From birth to one would be a baby and from one to eight is a toddler and the treatment is different in both cases. And the back slaps, for example, on a baby, you would need to put the baby onto your lap, support the chin and we'll do five back slaps and that way obviously you will keep them nice and safe. With a toddler, for example, sometimes it's actually better to stand them up, lean them forward, support them before doing the back slaps.
Lucy Piper: We've also got mom Laura, with Finley and I know Laura has got a question for Paul.
Laura McKie: Paul do we always have to remove the obstruction?
Paul Sheehan: You have to be very careful when removing any obstruction form the mouth. One thing we never do is what we called a blind sweep. Now a blind sweep basically is feeling down back to the throat and trying to scoop an object out from the back.
If you can't see the object then you wouldn't put your fingers down at the back of the throat. If you scratch the back of the throat, the throat becomes swollen, it will grip the object and they choke a little more. They could vomit and then they'll choke on their vomit and a lot of the time, because the object is wet and slimy, all you're going to do is push it further down and they will just choke even more. So, we have to be careful.
Lucy Piper: Could you show us perhaps Finley wouldn't mind showing how you would, it's quite funny as a mother perhaps getting the children to position to do the back slap so very well saying slap the back but, I wanted if you could perhaps do a little demo here. So, if Finley is choking.
Paul Sheehan: If possible what we need to do is lean him forward.
Laura McKie: Lean forward.
Paul Sheehan: And bring the head down a little. Bring your head down a little bit. Now if we support on the shoulder.
Laura McKie: Like that.
Paul Sheehan: That's it. Now, you do back slaps right between the shoulder blades, using the heel of the hand. And what we'll do then is we would hit five times fairly hard on the back and listen and then in between the slaps just check to make sure, to see if the object has actually moved, because obviously if we hit him twice and it's removed, we don't have to keep hitting him. We want to clear the object. So, hit, say count to three in between, check the mouth and then if it hasn't cleared we do the next back slap. But infants this actually works better, but if it's a toddler, we actually, it's better with the standing.
Lucy Piper: And if you have done all this at home and you have done that slapping of the back and your child is still very distressed, what stage do you call the ambulance?
Paul Sheehan: Well, we'll do is, we can do the back slaps and we go on then to do a thing called abdominal thrust.
Lucy Piper: And what's that?
Paul Sheehan: Well, the abdominal thrust basically -- if it's a toddler, sorry we'll do abdominal thrust and chest thrust. Could it be easier if I just demonstrate. Finley can I -- would you like to come here for a minute, please Finley.
Lucy Piper: Good boy Finley! Good boy!
Paul Sheehan: Come here. Okay, can you stand up for me? Would you stand up? Basically, what we'll do is, just lean forward from me a second Finley. Thank you. Remember I said, we'd to support the shoulder; we'll do up to five back slaps, if it doesn't work then we come behind them and what we want to do is -- excuse me Finley if I can just get under the arms, we want to find the bottom of where the breast bone meets.
Lucy Piper: Yeah.
Paul Sheehan: We put one hand into play; grab hold and then covering on and we pull in fairly tightly. And it's a short and sharp movement, probably pulling we can do that up to five times. If that doesn't work then the abdominal thrust basically is making what we call a safe side-fist. The thumb goes into the palm of the hand. You curl your fingers and you use the flat of the hand. You come down just below the boundary of the rib-cage here, at the upper level of the abdomen, you cover your hand and then from there the movement, I won't actually do it to you Finley, because I will do it here. Just pull in and out, short and sharp. And we can repeat that five times. But there's one very important rule, anytime you do an abdominal thrust, even if I did it once and the object came out of the mouth, what I must always do is get the person checked by a doctor, because it's such a violent maneuver.
Lucy Piper: Okay, thank you very much Paul. So to summarize, remove the danger, make sure the area aligning the child is safe, try the appropriate treatment and if that doesn't work call an ambulance.
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