Although we hope we never have to face the possibility of a young child swallowing or inhaling an object, choking poses one of the greatest risks to young children. Here are steps you can take in the event that you are faced with this emergency situation:

When an object blocks the flow of air to the lungs, a child cannot talk and his face will turn from bright red to blue. Have someone call for medical assistance while you deal with the situation immediately.

For any age child:

  • Let the child cough!
  • Don't try to remove the object with your fingers.

For a child under one year:

  • Do not use the Heimlich maneuver.
  • Be gentle.
  • Place the infant head down, facedown on your forearm.
  • Rest your forearm against your body. (if the baby is large, lay him face-down on your lap with his head lower than his trunk.)
  • Give four rapid back blows, using the heel of your hand, between the shoulder blades.
  • If the child still cannot breathe, turn him on his back, place him on a firm surface, and use only two fingers to deliver four rapid chest thrusts over the breastbone.
  • If he is still not breathing, open the airway, using the tongue-jaw lift technique and attempt to see the object. Only if you can see it sweep the object out with your finger.
  • If he doesn't start breathing on his own, try giving two breaths by mouth-to-mouth or mouth-to-nose techniques.
  • Continue these steps until medical help arrives.

For a child over one year:

  • Do the Heimlich maneuver until the object comes out.
  • Place the toddler on his back.
  • Kneel at the child's feet.
  • Place the heel of one hand in the center of the child's body between the navel and the rib cage. Place your second hand on top of your first.
  • Press into the abdomen with a rapid inward and upward thrust. Be gentle!
  • If the object does not come out, open the child's mouth by using the tongue-jaw lift technique. Only if you can see the object, sweep it out with your finger.
  • If the child doesn't start breathing, give mouth-to-mouth resuscitation.
  • If unsuccessful, repeat a series of six to 10 abdominal thrusts.
  • Continue to repeat these steps until emergency help arrives.

Make sure as many people in your program as possible are up-to-date on mouth-to-mouth/nose resuscitation, emergency choking procedures, and CPR. Keep an easy-to-read, easy-to-see emergency procedure chart in every room.

This article originally appeared in the April, 2001 issue of Early Childhood Today.