Advice for choking incidents

Lots of people get their first aid knowledge from TV and films, and how often have you seen soap characters go straight to abdominal thrusts to help a choking patient?

In the UK, we advise that back blows are always the first resort to remove an obstruction in a responsive patient’s airway once coughing has failed.

Someone who came on one of our courses recently contacted us to say that they had to treat someone for choking not long after they had finished their training. The information had helped them save someone’s life so we thought it would be worth reminding everyone of the basics.

Remember:

• Always shout for help first but stay with the patient
• As soon as you see someone choking, encourage the person to cough to try and clear the obstruction themselves. If this fails then you need to take action.
• Get the patient to bend forwards so that their head is below chest-height (for a small child, bend them over your knee)
• Use the palm of your hand to deliver up to five firm blows between the shoulder blades, checking after each blow to see if the obstruction has been dislodged.

When delivering training to students, it is important to use the correct terminology. A “back blow” is more forceful than a slap but care must be taken not to injure the patient.

If the back blows are unsuccessful, move onto abdominal thrusts.

• Stand behind the patient and wrap your arms around their waist
• Make a fist with your thumb pointing inwards and place just above the belly button. Hold the fist with your other hands and pull sharply inwards and upwards.
• Check to see if the obstruction is cleared and repeat four more times if necessary.
• Alternate between back blows and abdominal thrusts if you need to and get someone to dial 999 or 112 for emergency help.

The problem with teaching the treatment for choking is that it is difficult for a student to judge the force required for both back blows and abdominal thrusts without practice but it is dangerous to practise on a healthy patient.

Using a choking trainer during teaching means that students can deliver both treatments on a dummy so that they can be sure to have the right technique in a real emergency situation.