You are working in a clinic doing a well-baby visit for a 6 mo old girl. Her mother and teenage brother are there with you.
The brother is eating some gummy bears while he plays on his mom’s phone.
He suddenly drops the phone, clutches his neck, and runs out the door.
What do you do?
People who are choking will often instinctively attempt to hide. You should immediately follow him.
You ask if he is choking, and he nods and is able to speak a weak ‘yes’.
How do you respond?
As it appears he has a partial obstruction, encourage him to keep coughing in order to dislodge the obstruction. Endeavour to keep him calm.
Unfortunately he now stares at you with wide eyes, and is completely unable to talk. You hear only a high pitched squeak when hhe breathes.
How do you respond?
This appears to be a total obstruction, and requires your action.
Call for help from other staff, and ask them to call 911.
Create space to work.
Deliver 5 sharp blows to the back, between the shoulder blades. If this is not successful, attempt 5 abdominal thrusts.
Unfortunately, the obstruction is not dislodged. He turns progressively more cyanotic, and then becomes unconscious.
How do you respond?
He should be carefully lowered to the ground. Begin chest compressions, stopping to look for an obstruction after a cycle of CPR (30 compressions).
Thankfully, after 10 chest compressions, a whole gummy bear pops out of his mouth, and you begin positive pressure ventilation. His colour and oxygen saturation improve, and 30 seconds later he begins breathing on his own.
The paramedics soon arrive and you hand over for further stabilization and assessment in the ED.
You are working in a clinic doing a well-baby visit for a 6 mo old girl. Her mother and teenage brother are there with you.