Choking & CPR In Infants – First Aid and More

Choking & CPR In Infants - First Aid and More

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Children are always out and about exploring, and therefore, chances of an accident occurring can be quite high. Choking and gagging are some of the common mishaps that infants are prone to. It is important to understand that choking is different from gagging by a few parameters. Gagging is a natural reflex, and it is located farther down the mouth. As the child grows older, it will move farther down the throat. Gagging is a protective reflex to prevent choking.

Choking, on the other hand, can be partial or total. With partial choking, the child is able to cough and will participate in removing the foreign body, while with total choking, the airways get obstructed, the cough cannot be generated, and the child may lose consciousness very rapidly. If a baby is coughing effectively when choking, it is best to let the coughing continue as it will help clear the airway. However, if that is not the case, knowing first aid and effective ways to quickly clear a blocked airway can save the baby’s life. Read on to more on the topic.

First Aid for Choking in Babies

Infants and babies are sensitive and prone to incidents such as choking, which is why they need to be handled with care at all times. Parents or guardians MUST know what to do if a baby chokes to provide immediate relief and prevent catastrophic consequences.

Food is a common choking hazard as young children might not be able to chew their food well and swallow it instead. It is important to understand the symptoms of choking so that the child can be given immediate and effective first aid.

How to Know If a Baby Is Choking

The following symptoms in a baby can be characteristics of choking:

  • The universal sign of choking is hands clutched to the throat.
  • Difficulty in breathing.
  • Skin colour turns bluish.
  • Loss of consciousness due to windpipe blockage.
  • High-pitched sounds while inhaling.
  • Inability to make any sound or cry uninterrupted.

kid choking due to food stuck in her airway

How to Save a Baby from Choking

Acting spontaneously is of utmost importance to prevent a choking baby from severe harm. Here are a few important steps to follow if a baby chokes:

1. Analyse the Situation Quickly

If a baby cannot breathe, cough or cry, it might be because something is blocking his airway. Several symptoms, such as those mentioned above, can help identify if the baby is choking. A quick analysis of the situation will aid in saving his life.

2. Clear the Blockage

Clearing the blockage promptly is necessary to allow babies to breathe normally and feel relieved. When a baby shows symptoms of choking, use one finger to lift the chin and take a look into his mouth and nose to remove any visible blockage or obstruction. If the baby is coughing, allow him to cough until the obstruction comes out. Do not pat the back while a baby coughs as this will allow the obstruction to slip further inside.

Checking blockage

3. Back Blows and Chest Thrusts

In a choking but responsive infant less than one-year-old, back blows and chest thrusts are used instead of abdominal thrusts, which we have also elaborated in the next point.

To provide back blows and chest thrusts, do the following:

  • Hold the infant in your lap, with his face down and head lower than his chest. The baby should be resting on your forearm. Put your forearm on your thigh.
  • Support the infant’s head and neck with your hand and be sure to avoid putting pressure on his throat.
  • Using the heel of your free hand, deliver five back blows between the infant’s shoulder blades.

volunteer demonstrating the back blow technique for choking babies

  • Using both hands and arms, turn the infant face up, so he is now resting on your other arm. This arm should now be resting on your thigh.
  • Once again, make sure the infant’s head is lower than his chest.
  • Using the fingers of your free hand, give up to five quick downward chest thrusts (one thrust every second) over the lower half of the breastbone.

volunteer demonstrating the chest thrust technique for choking in babies

  • If the obstruction is not relieved, turn the infant face down on your other forearm and repeat the process.
  • Continue doing these steps until the infant begins to breathe or becomes unresponsive.

4. Abdominal Thrusts

These steps should only be used when a kid is responsive and older than
one year of age.

To properly perform the abdominal thrusts, do the following:

  • Stand behind the responsive kid. Wrap your arms around his waist under the ribcage.
  • Put the side of your fist above the kid’s navel in the middle of their belly. Do not press on the lower part of the sternum.
  • With your other hand, hold the first fist and press forcefully into the kid’s abdomen and up toward his chest.
  • Continue performing these thrusts until the obstruction is relieved or until the kid becomes unresponsive.

volunteer demonstrating abdominal thrust technique for choking in kids

Watch this video to learn both the techniques better.

Video: First Aid for Choking Emergencies

When the baby is unresponsive or unconscious, and his breathing or heartbeat stops even after providing first aid for choking, you must provide CPR (Cardiopulmonary Resuscitation) and seek immediate medical attention. Continue reading to understand what CPR is and how it is done.

What Is CPR?

CPR or Cardiopulmonary Resuscitation is a life-saving procedure performed when a person’s heartbeat or breathing stops and shows no signs of life. CPR involves forceful rescue breathing that provides oxygen to the lungs. The procedure also involves chest compressions which help with the blood flow.

These procedures should continue until the child recovers or medical aid arrives, as lack of oxygen or stoppage of blood flow can result in permanent damage to the child. CPR for infants should ideally be done by someone who is trained with a CPR accredited course, but this can be done by parents too. Therefore, it is imperative to know the techniques in order to stay fully equipped in case a situation demands this to be performed.

What Calls for CPR in Babies

As discussed earlier, CPR is performed when the body shows no signs of life, i.e., the baby has stopped breathing, or his heart has stopped beating. The CPR procedure should be performed when all other methods of reviving the child fail. It is often done to restore blood circulation and flow of oxygen in babies or kids who have had cardiac arrests or suffered from choking, suffocation, shock, serious injury and other severe accidents.

When to Perform CPR on Babies

A CPR procedure should be performed on a child if any of the following symptoms are noted:

  • When there is no breathing.
  • If the child has no pulse.
  • If the child is unconscious.

How to Perform CPR in Babies

In case of an emergency, it is appropriate to call the ambulance at the earliest. If you are alone with the baby with causality, then knowing how to give a CPR could prove to be useful. Perform CPR for a minute and then call for an ambulance and repeat the procedure until the ambulance arrives. Following are the steps to be followed to perform CPR on a baby.

1. Analyse the Problem Quickly

Identify the problem by noticing the symptoms mentioned above. If the baby is not conscious, try to get a response by gently tapping the sole of the foot and by calling out his name. The entire process should be done under 10 seconds, preferably. If the baby is unconscious and has trouble breathing, open the airway, check his pulse and give rescue breaths.

checking for signs of breathing in infant

2. Open the Airway and Check the Pulse

Look and listen for normal breathing by kneeling at a right angle to the baby’s chest. Push down the forehead, tilt the head back and lift the chin with one hand. Now look for and remove any obstruction in the mouth and the nose. Check for the pulse on the inside of the elbow by using your middle and index finger. If there is no pulse or the baby is not breathing, call for help/ambulance right away and perform CPR.

Checking pulse rate of the infant

3. Give Two Rescue Breaths

Follow these steps to give rescue breaths to the baby:

  • Open the baby’s airway and ensure that it is clear.
  • Seal your lips around baby’s nose and lips, blow steadily into the baby’s lungs and see if it rises as you blow the air.
  • Once the chest rises, stop blowing and allow it to fall.
  • Repeat this process two times.

Giving rescue breaths to the infant

4. Give 30 Chest Compressions

  • Place the baby on a firm surface and find the centre of his chest.
  • Find the midpoint on the sternum, between an imaginary line joining the nipples and where the lowest ribs join in the middle.
  • Press down to a third of the depth of the chest. Press 30 times at the rate of 100 compressions per minute.
  • Give two rescue breaths after 30 compressions.
  • Repeat this cycle of 30 compressions and 2 breaths, at least five times, or until help arrives.

Giving chest compression to a infant

Watch this video for a better understanding of how CPR is performed on babies.

Video: How to Perform Infant CPR

Precautions to Take While Performing CPR

When performing CPR on a baby, one must follow these precautionary measures:

  • Do not start the CPR process if the child has signs of normal breathing, movement or coughing as doing so may cause the heart to stop beating.
  • If you are not trained to perform a CPR or do not have a basic understanding of how to perform a CPR, seek professional help immediately and do not attempt to give CPR by yourself.
  • If the child has a spinal injury, do not move the head or neck while pulling the jaw forward, and do not let the mouth close.

Tips to Prevent Choking in Children

Most accidents that require CPR are preventable if suitable precautions, such as the ones given below, are taken:

  • Ensure that you offer mashed or pureed food to your baby when you start feeding solids up until the baby begins teething and can consume finger foods.
  • Avoid using the teething medication as it may numb the baby’s throat and make swallowing difficult.
  • When the baby starts eating solid foods, ensure he is sitting up for his meals.
  • Make sure all vegetables are soft-cooked.
  • Finger food should be cut into small pieces.
  • Encourage the child to eat slowly and chew well.
  • Choose snacks that are easy to swallow.
  • Keep small objects like buttons and seeds out of reach.
  • Above all, keep an eye on your child, especially when he is eating, as he may not be able to alert you if he is choking.

When to Contact Medical Help

In case of an emergency, it is best to call for medical help without delay. If your child suffers from a fatal accident, call for medical aid immediately and continue providing first aid while the team of professionals arrive.

Parents never compromise the health of their children. Knowledge of providing first aid can come handy when mishaps, such as choking, occur. Although measures can be taken to prevent such accidents, if there’s a need, the information and tips provided in this article can help you manage the situation and seek medical help. Having said that, we strictly advise parents to avoid performing any techniques without being trained. A proper training under the guidance of a professional can help you ensure you are following the right methods whenever needed.

Also Read: Guide to SIDS and Sleep Safety Measures for Infants