Choking

This is a respiratory emergency, which occurs when the airways are partially or totally obstructed by food or foreign body.

The patient has difficulty in breathing and the rate and depth of breathing increases. There may be frothing at the mouth. There is blueness of the lips and the fingernails. If it is not corrected immediately, there is hypoxia to the brain and mental confusion is seen. The afflicted individual is unable to talk and usually grips the throat with one hand.

The management of choking is as follows:
• When alone, the person or victim should lean over a firm object and press the abdomen against it just below the ribcage.
• The rescuer should make a fist of the left hand and place it over the victim's abdomen just above the navel. The thumb end should be towards the abdomen and knuckles face upwards. The other palm should be placed over the first and sharp inward and upward thrust should be administered. Continue till obstruction is cleared.
• When patient is unconscious, place him / her supine. Remove foreign body if visible. No blind sweeps allowed. If no breathing, position head & give breaths. Kneel astride one or both of the victim's thighs and place the heel of one hand just above navel. Place other hand on top and with fingertips lifted off the chest, give up to 5 quick thrusts inward & upward. Check & hook out the visible foreign body. Continue till help arises.
• In infant, lay the infant face down with the legs straddled on your forearm or lap with head lower than the trunk. Give 5 sharp slaps between the infant's shoulders. Then lay the infant face up along your other arm. Place 2 fingers on the lower half of the breastbone. Give 5 sharp downward thrusts into the chest. Continue back slaps and chest thrusts. Check for foreign body in mouth & remove if visible. Give CPR also.

To prevent such casualties, it is important that the small and rounded articles in the household are kept out of reach of children. They should not eat slippery and rounded food articles like groundnuts etc. till they are a little older. These should be provided to them in a grinded form. Adults should be careful while working and small things should not be kept in between the teeth. The loose dentures and tooth should be removed. "Prevention is always better than cure."