choking

1. choking Annual compulsory education Revised April 2013

2. Learning Objectives • How to prevent choking • What are the signs and symptoms of choking • Choking techniques Revised April 2013

3. To Prevent Choking • Allow enough time for the Resident to completely chew & swallow their food. • Do not mix food and fluids when feeding a resident. • Position the Resident up-right when feeding • Have the Resident slightly tuck their chin when swallowing • Sit down at the Resident’s level and face them when feeding. • Do not ask the Resident to talk or laugh when their mouth is full of food • Check Resident’s mouth for pocketing during and after meal time. Revised April 2013

4. Signs of Choking • Inability to speak, cough or breath • Change of color to the face (red then turns bluish) • Look of panic with wide eyes • One or both hands clutching their throat • May try to leave for a private area • Acting agitated or trying to get attention Revised April 2013

5. When Someone is Choking If the Resident is coughing: - Encourage them to keep coughing and stay close by - Do not let the Resident go off on their own If the Resident is unable to cough: - Ask the Resident “Are you choking?” - Ask the Resident “Can I help you?” - Call “Help – Code Blue” - The first person to respond should be sent to page Code Blue Revised April 2013

6. Choking Maneuver • Stand behind the Resident with one leg between theirs. • Wrap one arm diagonally across the Resident’s chest. • Bend the Resident over at the waist until the Resident’s upper airway is parallel to the ground. • Deliver 5 firm back blows between the shoulder blades with the heel of your other hand. If this does not dislodge the foreign object, move on to the next step… Revised April 2013

7. Choking Maneuver (step 2) • Continue to stand behind the Resident. • Make a fist with one hand and place it above the Resident’s belly button. • Place other hand over the fist & pull up sharply in & up (J motion) – Do this 5 times. • Continue the cycle of 5 back blows and 5 abdominal thrusts until the foreign object is dislodged and the Resident can cough &/or breathe. Revised April 2013

8. For a Larger Resident • If you can not reach far enough around the Resident to perform abdominal thrusts… - Stand behind the Resident with your leg between theirs. - Wrap both of your arms around the Resident’s chestjust under the armpits. - Make a fist & place your thumb in the middle of the Resident’s chest and place your other hand over your fist. - Pull straight back (sharply & deeply)towards you 5 times. If this does not dislodge the foreign object, move on to Step 2. Revised April 2013

9. For a Larger Resident (step 2) Perform 5 firm back blows. • Wrap your arm diagonally across the Resident’s chest while standing behind them. • Lean the Resident forward at the waist (only to the point where you will not drop them). • Use your free hand to perform the 5 back blows. Continue the cycle of 5 chest thrusts & 5 back blows Until the foreign object becomes dislodged and the Resident can cough &/or breathe. Revised April 2013

10. In a Wheelchair or Seated Position • Lock the wheels of the wheelchair. • Kneel or crouch behind the wheelchair. • Wrap both of your arms around the Resident’s abdomen. • Make a fist with one hand & place your thumb just above the Resident’s belly button. • Grasp this fist with your other hand. Pull sharply in & up (J motion) 5 times. If this does not dislodge the foreign object, move on to Step 2. Revised April 2013

11. In a Wheelchair or Seated Position (step 2) • Move your fist to the middle of the Resident’s chest. • Place your other hand over your fist & pull straight back sharply – Do this 5 times. • Continue the cycle of 5 abdominal thrusts & 5 chest thrusts until the foreign object becomes dislodged and the Resident can cough &/or breathe. Revised April 2013

12. Unconscious Resident Please Note: ** A HCA can not perform the choking maneuver on an unconscious resident.** Revised April 2013

13. BSF Requirements Annual completion of Compulsory In-service. (HCAs, OT/PT, ADP) Annual completion of Choking Skill Test. (HCAs, OT/PT, ADP) (this must be signed off by a nurse or the Staff Development Department) Revised April 2013