Hand Placement for Abdominal Thrusts on Choking Child

Preface:

You may already know that you should give abdominal thrusts to a conscious choking child, but you might not be familiar with the exact hand placement and precise details about this technique.

This ultimate guide provides all these details, offering step-by-step instructions with illustrations to help you perform abdominal thrusts effectively and safely, potentially saving a life from choking.

Note:

Children under age 5 are at the highest risk for choking injuries and death, often due to small objects. Choking is life-threatening as it blocks the airway, preventing oxygen from reaching the lungs and, consequently, the brain. Brain damage can occur in as little as 4 to 6 minutes without oxygen.

When to Give Abdominal Thrusts to a Choking Child

Do not administer first aid if the child can cough forcefully, cry, or speak, as a strong cough can often naturally expel the object.

The following signs indicate a complete airway obstruction (severe choking) and necessitate immediate first aid. Administer abdominal thrusts if the child:

• cannot cough effectively
• cannot breathe
• cannot speak
• makes high-pitched squeaking noises or no sound at all
• has pale or blue skin

Note:

Give abdominal thrusts only when the child is conscious. If the child becomes unconscious, do not continue with abdominal thrusts; start CPR immediately.

Perform Abdominal Thrusts on Choking Children: A Step-By-Step Guide

Step 1: Positioning

• Stand or kneel behind the child, depending on their size.

For smaller children, such as toddlers, it is best to kneel.

If the child is larger and taller, standing behind them may be more effective.

• Have the child stand up straight yet lean forward a bit.
• Wrap your arms around their waist, just the upper abdominal region.

Tips: When helping a choking victim shorter than you, lower yourself to their height. This helps prevent excessive pressure on the rib cage and reduces the risk of causing broken ribs or other injuries during abdominal thrusts.

Step 2: Make a Fist and Position It Correctly

• Make a fist and place it about two inches above the child's belly button, where the diaphragm is located, with the thumb side facing toward the abdomen.
• Then, cover this fist tightly with your other hand.

Step 3: Perform 5 Quick and Hard Abdominal Thrusts

• Press your fist into the abdomen and perform 5 quick, hard upward and inward thrusts.
• After each thrust, check to see if the blockage has been cleared before proceeding.

Tips:

If the blockage remains, then repeat the cycle of 5 back blows followed by five abdominal thrusts, as recommended by the American Red Cross for comprehensive choking first aid.

Repeat until the blockage is cleared, paramedics arrive, or the child becomes unconscious. If the child loses consciousness, immediately stop abdominal thrusts and begin CPR right away.

Safety Tips:

1. For small children, use gentle yet firm pressure to prevent harm to internal organs.
2. Do not thrust hard enough to lift the child off his feet. Unlike with adults, where you may use enough force to lift them.
3. Keep your elbows out to minimize contact with the child's ribs.
4. Do not attempt to dislodge an obstruction by holding a child upside down by their feet; this approach is ineffective and risky as dropping the child could lead to further injury.
5. Never blindly insert your fingers into their mouth to clear a blockage; this may worsen the situation by pushing it deeper. Only attempt to remove the blockage with your fingers if it is clearly visible and easily accessible.

When to Seek Emergency Help

If you’re alone with a choking child, begin first aid immediately and then call 911 using a speakerphone. This allows you to continue administering first aid while communicating with emergency services.

Important: Do not waste crucial first aid time searching for your phone to call 911 if you're alone and help isn't immediately available. Prioritize first aid, especially if calling is not straightforward.

If someone else is present, instruct them to call 911 immediately while you focus on providing first aid.

Post-Choking Care: Ensuring Your Child’s Safety and Health

Once the object is removed, the child will likely start coughing to clear the airway and should resume normal breathing within seconds.

Reassure the child, letting them know they are safe now, and have them sit down if needed. Children can often feel more confused and scared than adults, so it's crucial to comfort them and confirm their safety.

Even if the choking episode seems resolved, it's important to have the child examined. Take them to an urgent care center, hospital, or their physician for a thorough check. Paramedics should confirm that the airway is completely clear, there are no remaining partial obstructions, and there are no internal injuries.