FIRST AID 2 - Airway Emergencies

FIRST AID 2 -Airway Emergencies March 2010 CANADIAN COAST GUARD AUXILIARY - PACIFIC

ABCs • ABC stands for: Airway Breathing Circulation • This is the Primary Survey

Airway Emergencies

Airway Emergencies • The airway is the passage through which the air moves from the nose and mouth to the lungs. • If anything blocks the airway, the person chokes and cannot get enough oxygen, and life is threatened. • This is an emergency, and you must give first aid to clear the airway.

Airway Emergencies

Causes of Airway Obstruction • An airway obstruction can occur if the tongue or swollen tissues of the mouth block the airway caused by: 1. An injury to the mouth 2. A severe allergic reaction 3. The tongue dropping to the back of the throat and blocked the airway

Causes of Choking • Any airway blockage caused by a foreign object or fluid is called choking.

Causes of Choking 1. Trying to swallow large pieces of food. 2. Excess alcohol, causing suppression of the gag reflex, and then choking on food. 3. Wearing dentures 4. Eating with talking excitedly or laughing or eating too quickly 5. Walking, playing or with food, small toys or other objects in the mouth

Signs and Symptoms of Choking • A person who is choking may have a partial or complete blockage of the airway. • A complete blockage will not allow breathing. • A partial blockage may be cleared by the person coughing.

Signs and Symptoms of Partial Obstruction 1. High pitched or wheezing sounds when breathing in 2. Coughing 3. Clutching at the throat with one or both hands

Signs and Symptoms of Complete Obstruction 1. May be conscious or unconscious 2. Unable to breathe 3. Unable to speak 4. Unable to cough 5. Face may appear bluish

Signs and Symptoms of Complete Obstruction • A conscious adult can usually indicate they are choking. • With an infant or small child who is conscious but not able to breathe assume they are choking on something.

First Aid for Choking • For a patient with partial airway obstruction do not interfere with their attempts to cough up the object. • If the patient is no longer able to cough or speak, treat as for complete obstruction.

First Aid for a Conscious Choking Adult with Complete Airway Obstruction 1. Ask “Are you choking?” 2. Summon someone to help you. 3. Attempt abdominal thrusts - stand behind the person and wrap your arms around their waist. 4. Make a fist with one hand and place the thumb side of the fist on the middle of the abdomen slightly above the navel.

First Aid for a Conscious Choking Adult with Complete Airway Obstruction 5. Grasp your fist with the other hand and give quick upward thrusts into the abdomen to dislodge the object. 6. Repeat until the choking stops or they become unconscious

Abdominal Thrusts for a Conscious Choking Adult with Complete Airway Obstruction • Use chest thrusts when you can’t reach far enough around the patient, or for women in late pregnancy 1. Place your arms under the patients armpits and around the chest. 2. Make a fist with one hand, place the thumb side against the centre of the patient’s breastbone.

Abdominal Thrusts for a Conscious Choking Adult with Complete Airway Obstruction This is not to be the lower tip of the breast bone and not on the ribs). 3. Grab you fist with the other hand and thrust inward. 4. Repeat until the object is dislodged or the patient becomes unconscious.

When to Stop Chest Thrusts, Abdominal Thrusts and Back Blows • Stop immediately if the object is dislodged or if the patient begins to breathe or cough. • Make sure the object comes out. • The thrust can cause internal injuries, and should be seen by EHS.

First Aid for Conscious Choking Children with Complete Airway Obstruction • The significant difference for treating a child over the age of 1, is use less force to expel the object • Make sure you are sitting or stable before starting • Otherwise use the same method as an adult

First Aid for Conscious Choking Infants with Complete Airway Obstruction • First determine if the infant is choking by observing if the infant can breathe, cough or cry or is coughing weakly or making high pitched sounds. • Do not use abdominal thrusts.

First Aid for Conscious Choking Infants with Complete Airway Obstruction • Turn the infant face down on your fore arm with the head lower than the body, and with the heel of your hand give five forceful back blows between the infant’s shoulder blades. • Then turn the infant over, with its head lower than its body.

First Aid for Conscious Choking Infants with Complete Airway Obstruction • Give five chest thrusts using your middle and index fingers on the breast bone one finger width below the nipple line. • Repeat back blows and chest thrusts until object is coughed up or infant becomes unconscious.

First Aid for Conscious Choking Adult Who Becomes Unconscious • If the obstruction cannot be removed the casualty may become unconscious. 1. Lower the casualty to the floor on their back. 2. Open the airway and look for an obstruction. 3. If seen, lift the lower jaw, remove the object by sweeping it out using a hooking action with your finger. 4. Be careful not to push the object deeper

First Aid for Conscious Choking Adult Who Becomes Unconscious 5. Next try to open the airway using head tilt/ chin-lift method

First Aid for Conscious Choking Adult Who Becomes Unconscious 6. Assess for effective breathing for 10 seconds. 7. If not breathing attempt to ventilate. 8. If air does not go into the lungs, retilt the head and try again. 9. If air still does not go into the lungs, assume the airway is still obstructed and begin the CPR sequence with 30 chest compressions.

First Aid for Conscious Choking Adult Who Becomes Unconscious 10. After those, open the airway and look in the mouth. 11. If you see an object, remove it. 12. If you cannot get air into the casualty’s lungs continue the CPR sequence, always looking in the mouth before the ventilation attempt. Keep trying to clear the airway. 13. If you see and change in the person’s condition, stop CPR and reassess the ABCs.

First Aid for Conscious Choking Adult Who Becomes Unconscious 14. Once you can breathe air into the casualty’s lungs, give two rescue breaths. 15. Then complete the primary survey by checking casualty for signs of circulation and checking and caring for severe bleeding. 16. If there are no signs of circulation, begin CPR.

First Aid for Conscious Choking Adult Who Becomes Unconscious 17. If the casualty has signs of circulation but is not breathing on their own, continue rescue breathing. • If the casualty starts breathing on their own, monitor the breathing and circulation, maintain an open airway, and get to EHS. • Put the casualty into the recovery position.

First Aid for an Unconscious Choking Adult 1. Open the airway and place your ear close to the person’s mouth, then look, listen and feel for signs of breathing for 10 seconds. Look at chest and abdomen for movement Listen for breathing sounds Feel for exhaled breath on your cheek If none of these signs are present the casualty is not breathing

First Aid for an Unconscious Choking Adult 2. Use the head tilt/ chin lift method to open the airway. 3. Attempt to ventilate. 4. If air does not go into the lungs, re-tilt the head and try again. 5. If air still does not go into the lungs, assume the airway is still obstructed and begin the CPR sequence with 30 chest compressions.

First Aid for an Unconscious Choking Adult 6. After those, open the airway and look in the mouth. 7. If you see an object, remove it. 8. If you cannot get air into the casualty’s lungs continue the CPR sequence, always looking in the mouth before the ventilation attempt. Keep trying to clear the airway. 9. If you see and change in the person’s condition, stop CPR and reassess the ABCs.

First Aid for an Unconscious Choking Adult 10. Once you can breathe air into the casualty’s lungs, give two rescue breaths. 11. Then complete the primary survey by checking casualty for signs of circulation and checking and caring for severe bleeding. 12. If there are no signs of circulation, begin CPR.

First Aid for an Unconscious Choking Child or Infant First aid for a child under 8 is the same as an adult with 30 compressions, but only performed with one hand. First aid for an infant is the same but with two fingers.

Choking Emergencies Problem Signals Care Casualty conscious Coughing forcefully Encourage casualty to partial obstruction Can speak and breathe continue coughing Wheezing If coughing persists, call EHS Casualty conscious Coughing weakly Get help complete obstruction Cannot speak or Begin abdominal thrusts breathe (back blows and chest thrusts for infants)

Choking Emergencies Problem Signals Care Casualty unconscious No breathing Call EHS complete obstruction Breaths won’t go in Begin CPR Look in casualty’s mouth for an obstruction after each cycle of compressions before attempting to ventilate

Head Tilt / Chin Lift • This can be used to stop the tongue from blocking the airway. • If the airway is blocked by swollen tissue, this may not work. • If air goes in from rescue breaths, the airway is clear.

FIRST AID 2 - Airway Emergencies