Fundamentals of the choking managment plan

“ I am so worried about introducing solids and my child choking”

As a mum I get it. Choking can feel overwhelming and confronting. Lets break it down to make it more understandable.

What is Choking?

Choking is when there is some type of obstruction in your child’s airway (trachea). When this happens, air is unable to flow normally into or out of the lungs, effecting your child’s ability to breathe properly. The obstruction can be labelled a partial obstruction or a complete obstruction.

Partial Obstruction:

Like the name suggests a partial obstruction will only partially occlude your child’s airway. Your child will still be able to breathe, cough, cry and make noise as some air can pass through the airway either side of the obstruction.

In this instance

• Keep your child upright

• Encourage your child to cough

Hopefully this will be all that is needed to clear your child’s airway.

Complete Obstruction:

A complete obstruction is when something is completely blocking your child’s airway. This causes your child to feel anxious. They will not be able to breath, cough and or make any noise. Choking is SILENT.

In this situation you will need to

• Implement your emergency DRSABC

• Call 000 for help

• Implement your choking management plan

The reason why we implement DRSABCD once again is that our children has the potential to deteriorate.

If your child’s airway is completely blocked they will deteriorate to cardiac arrest. Once again if your child is NOT breathing start CPR. 

Choking management plan:

If you notice your child has a full obstruction. Unable to speak, breath and cough.

Call triple zero (000) for an ambulance.

Step 1:

Deliver up to five back blows- checking after each to see whether the blow has relieved the obstruction.

Note: The aim is to free the obstruction rather than give all five back blows.

Back Blows Position:

Large children may either stand or sit. Small children or infants may be placed with their head downwards along or across first aider’s thighs. The aim here is to utilize gravity where possible and have the child’s bottom higher than their head. Using the heel (palm) of one hand deliver a forceful blow in the middle of the back between the shoulder blades.

Step 2: Deliver up to five chest thrusts. Checking after each to see whether the thrust has relieved the obstruction. Note once again the aim is to free the obstruction rather than give all five chest thrusts.

Chest thrust Position:

Children may either sit or stand against a firm support (wall or chair back). Infants should be placed with their face upwards i.e., supine position along a first aider’s thigh with their head supported. Apply a sharp, forceful chest compression delivered at the same point as for CPR.

If the obstruction is not relieved continue to alternate between chest thrusts and back blows.

If your child becomes unresponsive and is still not breathing start CPR and wait for help to arrive.

Download your choking management guide here