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.