This article throws light on the necessary intervention and management if a person is found to be choking. The techniques discussed here will help physicians understand the first line of action required in such an emergency.

Symptoms of choking

Choking is a life-threatening medical emergency that happens when an item lodges in the throat, obstructing the airway. Because choking stops a person from breathing, it deprives the brain of oxygen. Without prompt assistance, choking may be deadly.

When someone is choking, they often clasp their hands to their neck in an effort to dislodge the obstruction. Several symptoms that someone is choking include the following:

•  Inability to communicate
•  Difficulty breathing
•  Squeaky breathing
•  Seak coughing
•  A red swollen face 
•  Lips or skin that turns blue
•  Apprehension

Frequently occurring causes

Choking is most often caused by food particles. However, individuals, particularly toddlers, may choke on little things such as toys, coins, and other small objects. Food and household objects may provide a choking hazard:

• Hotdogs or sausages 
• Fishbones
• Popcorn
• Confectionery or chewing gum
• Whole, smaller fruits, such as berries and nuts
• Ice cubes, latex balloons, marbles, pen caps, buttons, batteries, earrings, erasers

"Five-and-five" strategy or the Heimlich Maneuver Technique

The following "five and five" strategy can be followed:

1. To begin, confirm that the subject is choking.
2. To deliver the five back strikes, begin by standing behind the individual.
3. Cross one arm over their chest to provide support.
4. Bend them at the waist to align their chests with the ground.
5. With the heel of the other hand, strike them five times between the shoulder blades.

If the individual is still choking, execute five abdominal thrusts:

1. Take a position behind the person who is choking, with one leg forward between their thighs.
2. Reach around their belly with one arm and find their navel.
3. Make a fist with their thumb towards the belly, right above their navel.
4. With the other hand, grasp this fist and press forward and upward with a rapid, jerking action.

Alter between five back blows and five abdominal thrusts until the obstruction is cleared otherwise the person may become unconscious.

Techniques for infants and young children

For children and babies, the initial step is to free the airway with your fingers, taking care not to push any items farther into the neck. If this does not work, try the following technique:

1. Take a seat and place the kid face down on your forearm, which should rest on your thigh.
2. With one hand, support their head and neck and ensure their head is lower than their abdomen.
3. With the heel of the other hand, smack up to five times between their shoulder blades.
4. If this does not work, tilt the kid upright and hold their head with one hand.
5. Place two fingers just below the nipple line on the breastbone.
6. At a pace of one per second, do five chest thrusts about 1.5 inches deep.
7. Repeat the back slaps and chest thrusts cycle until the youngster expels the item or loses consciousness.
8. If a person becomes unresponsive, get assistance and begin CPR.

Technique for adults and children (9 years and older) 

1. Ascertain that the subject is resting flat on their back.
2. Kneel next to them.
3. With straight elbows, stack the hand's palms down in the middle of the chest.
4. Lean forward and begin chest compressions by pressing down at least two inches per minute.
5. Allow the individual's chest to fully expand after each compression.
6. After 30 compressions, tilt the individual's head, elevate their chin, and provide two 1-second rescue breaths.
7. Repeat the procedure until the individual regains consciousness or professional medical assistance comes and takes over.

It is critical to remember that compression-only CPR at a pace of 100 compressions per minute is preferable to no CPR at all, for example, if the rescuer is unable or unable to provide rescue breaths.

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

The author is a practising super specialist from New Delhi.