What to do if your child is choking
Airway obstruction, including choking, suffocation and strangulation, is the leading cause of unintentional death in the United States among children under the age of 1. Worse, it can kill silently and quickly.
To prepare yourself, take a CPR class and practice the skills you learn. (To find a class near you, contact the American Heart Association, 800-242-8721, americanheart.org; the American Red Cross, 202-303-4498, redcross.org; or the YMCA, 888-333-9622, ymca.net.) In the meantime, here's a primer on what to do if you suspect your child is choking.
What to look for: Sudden inability to speak or cry; weak, ineffective coughs; and high-pitched or no sounds while breathing in. Fingers and lips may be blue-tinged, with the discoloration spreading to the arms, neck and chest. Older children may make the universal sign of choking (hands at the throat).
WHAT TO DO
If child is 1 year or younger and conscious:
1. Position the infant facedown along your forearm, head lower than his body; support his jaw and head with your hand. If necessary, sit or kneel, resting your arm and the infant's torso in your lap or on your thigh.
2. Deliver up to five "back blows" (strike the baby's back with the heel of your free hand between the shoulder blades). Stop if the infant expels the object or begins to cough or breathe.
3. If the object is not expelled after five back blows, turn the infant onto his back while supporting the head. Place two fingers on his breastbone, one finger width below the nipples. Using your fingers, give up to five "chest thrusts" (quick downward thrusts to the chest) at a depth equal to one-third to one-half the depth of the infant's chest. Stop if the object is expelled or the infant begins to cough or breathe.
4. Alternate performing five back blows and five chest thrusts until the object is expelled or the infant becomes unconscious.
5. If the infant becomes unconscious, proceed to Step 1 below.
If child is 1 year or younger and unconscious:
1. See if you can rouse the infant: Flick the bottom of his foot or rub his back.
2. If the infant doesn't respond, do the following:
- Lay the infant faceup on a firm surface, tilt his head back slightly and lift his chin. Open his mouth and look for a foreign object. If you see an object, remove it; do not stick your fingers into the infant's mouth unless you can see the object.
- See if the infant is breathing: Look at his chest to see if it is moving, listen for breathing and feel his chest to see if it is moving. If he is breathing, the infant likely isn't choking. Call 911 and follow the emergency dispatcher's instructions.
- If the infant is not breathing, perform "rescue breaths": Place your mouth over his nose and mouth to form a seal. Give two gentle breaths lasting about 1 second each.
- As you perform the rescue breaths, watch to see if the chest rises (this means air is getting in). If so, look for any movement, coughing or breathing. If any of these are present, turn him onto his side and call 911.
- If the infant's chest doesn't rise as you perform rescue breaths, or if he shows no movement, coughing or breathing, assume there is an airway obstruction. Perform five chest thrusts to try to remove the object (see Step 3 above).
- Call 911 regardless of whether the baby expels the object or shows any movement, coughing or breathing.
- Continue chest thrusts until the object is expelled, help arrives or the infant shows any movement, coughing or breathing.