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First Aid Of Asphyxia And Choking By Dr. Hanan Said Ali.
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Learning Objectives: **Define of Asphyxia **Identify the classic signs of asphyxia.**Perform first aid of asphyxia in case of drowning**Demonstrate first aid of inhalation of toxic gases**Define choking.**List causes of choking**Identify symptoms and clinical signs of choking.**Perform first aid for choking (Heimlich Manoeuvre) for different age groups.
Definition of Asphyxia *A condition in which an extreme decrease in the concentration of oxygen in the body accompanied by an increase in the concentration of carbon dioxide leads to loss of consciousness or death. * Asphyxia can be induced by choking, drowning, electric shock, injury, or the inhalation of toxic gases.
Classic signs of asphyxia ...*- congestion of the face - due to venous congestion (venous return to the heart is prevented) .*- facial oedema - increased venous pressure causes tissue fluid transudation. *- cyanosis - excess de-oxygenated haemoglobin in the venous blood
*- petechial haemorrhages in the skin and eyes (particularly the eyelids, conjunctiva, sclera, face, lips and behind the ears) – due to raised venous pressure
First Aid Of Asphyxia In Case Of DrowningAim Of Care1- To restore adequate breathing.2-To keep the victim warm. 3-To arrange urgent removal to hospital.First Aid Asphyxia1- Rescuer the victim from the water to safety.2- Keep her head lower than the rest of the bodyto reduce the risk of her inhaling water.
3 -Lay the victim down on her back on a rug or coat.4-open the airway and check breathing ;be prepared to give rescue breaths and chest compression if necessary.
5-place the victim in the recovery position if she is breathing.
6-Treat the victim for hypothermia; remove wet clothing if possible and cover her with dry blankets.7- Give the victim warm water, if she regains full consciousness.8-Dial,the ambulance even if she appears to recover fully.
First Aid Of inhalation of toxic gases1-Dial the ambulance.2-Ask for both fire and ambulance services. If the victim' clothing is still burning, tray to extinguish the flames3- Move the victim into fresh air.4-Support the victim and encourage him to breath normally .3-Treat any burns or other injuries.
6-Encourage the victim to sit upright to aid breathing.7-stay with the victim until help arrives.8-monitor and record vital signs- level of response pulse, and breathing. If the victim is unconsciousness start CPR
Definition of Choking*Is the mechanical obstruction of the flow of air from the environment into the lungs. * Choking prevents breathing, and can be partial or complete, with partial choking allowing some, although inadequate, flow of air into the lungs.
Definition of Choking Cont.Prolonged or complete choking results in asphyxiation which leads to hypoxia and is potentially fatal.
Causes of choking*- Trying to swallow large pieces of poorly chewed food. *- Drinking alcohol before or during meals. Alcohol dulls the nerves that aid in swallowing. *- Wearing dentures. Dentures make it difficult to sense whether food is fully chewed before it is swallowed.
*- Eating while talking excitedly or laughing. *- Eating too fast. *- Walking, playing, or running with food or objects in the mouth.
Symptoms and Clinical Signs*- The person cannot speak or cry out. *- The person's face turns blue (cyanosis) from lack of oxygen. *- The person desperately grabs at his or her throat. *- The person has a weak cough, and labored breathing produces a high-pitched noise. *- The person does any or all of the above, and then becomes unconscious.
First Aid for Choking (Heimlich Manoeuvre)Adults: Conscious Victim1. Choking is indicated by the Universal Distress Signal (hands clutching the throat).
2. If the victim can speak, cough or breathe, do not interfere. 3- If the victim cannot speak, cough or breathe, give abdominal thrusts (the Heimlich manoeuvre). 4-Reach around the victim's waist.5-Position one clenched fist above navel and below rib cage.
5- Grasp fist with other hand. Pull the clenched fist sharply and directly backward and upward under the rib cage 6 to 10 times quickly.
In case of extreme obesity or late pregnancy.1- give chest thrusts. Stand behind victim.2-Place thumb of left fist against middle of breastbone, not below it. 3-Grab fist with right hand. Squeeze chest 4 times quickly.
6-Continue uninterrupted until the obstruction is relieved or advanced life support is available. In either case, the victim should be examined by a physician as soon as possible.If Victim Becomes Unconscious 1. Position victim on back, arms by side. 2. Shout for "Help". Call the local emergency number. 3. Perform finger sweep to try to remove the foreign body
4. Perform rescue breathing. If unsuccessful, give 10 abdominal thrusts (the Heimlich manoeuvre)5. Repeat sequence: perform finger sweep, attempt rescue breathing, perform abdominal thrusts, until successful. 6. Continue uninterrupted until obstruction is removed or advanced life support is available.
7. After obstruction is removed, begin the ABC's of CPR, if necessary.
Conscious Child (Over 1 year old)To dislodge an object from the airway of a child: *- Perform abdominal thrusts (the Heimlich manoeuvre) as described for adults. Avoid being overly forceful.
Unconscious Child (Over 1 year old)If the child becomes unconscious, continue as for an adult except:*-Do not perform blind finger sweep in children up to 8 years old. Instead, perform a tongue-jaw lift and remove foreign body only if you can see it.
Conscious Infant (Under 1 year old)1. Support the head and neck with one hand. 2-Straddle the infant face down over your forearm, head lower than trunk, supported on your thigh. 3-Deliver four back blows, forcefully, with the heel of the hand between the infantÕs shoulder blades.
3. While supporting the head, immediately sandwich the infant between your hands and turn onto its back, head lower than trunk. 4. Using 2 or 3 fingers deliver four thrusts in the sterna (breastbone) region. Depress the sternum 1.5-2.5 cm. for each thrust. Avoid the tip of the sternum.
5. Repeat both back blows and chest thrusts until foreign body is expelled or the infant becomes unconscious.
Unconscious Infant1. Shout for help. Call the local emergency number. 2. Perform tongue-jaw lift. If you see the foreign body, remove it. 3. Attempt rescue breathing. 4. Perform the sequence of back blows and chest thrusts as described for conscious infant.
5. After each sequence of back blows and chest thrusts, look for the foreign body and, if visible, remove it. 6. Attempt rescue breathing. Repeat steps 4 and 5. 7. If foreign body is removed and victim is not breathing, begin the ABC's of CPR.