Children and Choking: Prevention and What to Do

Last updated on September 4th, 2015 at 09:00 pm

Child CPR

the Heimlich maneuver

Recently, in the classes I have been teaching there has been an overwhelming amount of questions regarding choking in children and how to prevent it and what to do when it happens?  With choking being one of the top 5 killers of children in the United States, there is never a bad time to cover choking in children and what we as parents and caregivers can do to prevent and deal with the situation.

Let’s face it, children choke on almost anything.  If you have children or are a caregiver to children then you know that children love to put new things into their mouths and taste test everything and the younger the child, the more stuff they will put in there without any regard for what it might be.   The questions of how to prevent choking in children has a lot to do with age.  What I tell new parents or soon to be parents and grandparents are to go home.  This may sound silly but home is where the battlefield is.  I tell them to go home and see their home from a new perspective.  We as adults see the world from very high up, our perspective tends to make us look down on most things in our homes.  A small child or infant will see the home from an entirely different perspective looking up at most things in the home.  So what I recommend to the adults is to go home and lie down on the floor in every room and see what an infant might see.   It’s a whole new world down there with things like splinters under wood furniture, nail heads or staples sticking out, strings from fabrics, and the most important thing of all being that the infant or small child will find everything you have lost under all your furniture, including pills, paperclips, popcorn, you name it.   So as I said before, go home and gain a child’s perspective on your home.

Preventing choking in older children has mainly to do with food and how it is prepared and eaten.   We have all said “don’t stuff your face” or “chew your food “a thousand times, but the preparation is where we can make a significant difference.   What I tell parents is to cut, cut and cut again.  With foods like hot dogs, grapes, fruit and many other solid foods, cutting beforehand is the key.   Other, lesser known culprits like popcorn, peanuts and even cereals can be broken down by simply putting them in a bag beforehand and crushing them a little bit to break them down.

What to do when the choking begins are the most important and the most frightening, but thinking is the key.

Baby CPRIf you have an infant that starts choking at home, the first step should be to bring the infant to you by taking them out of whatever apparatus they are in at the moment, highchair or bouncer for example.  Secondly, you should scream for anyone you are with to call 911 and inform them of a choking infant, or you may have to bring baby to the phone and call 911 while relieving the choking yourself.   Even if the choking was sudden and the event ends right away, at least help is on the way.   The third thing should be to be seated and position the infant face down with the legs straddling your arm and your hand on the infants jaw, all while keeping the baby’s head pointed down in order to use gravity should anything come out or loose.  You will use the palm of your free hand to strike down, but towards the head of the infant, between the shoulder blades 5 times. Then you will put your free hand on the back of the baby’s head and sandwich the baby and flip them over to your other leg and then place your two fingers between the baby’s nipples and do 5 chest compressions or chest thrusts. You will repeat this until the object is removed, the baby starts breathing, or the baby becomes unconscious.

Should the baby go unresponsive, lie the baby down on a hard, flat surface and begin cpr on the baby.

Choking for the older child is much the same as choking for an adult, just on a smaller scale.  If you notice an older child that appears to be choking, you can ask them “are you choking? “ and if given confirmation that they are choking then you will kneel down behind the child, so you can be roughly the same height, and use the Heimlich maneuver, (see the picture at the top of the page) the same one you use on adults, to relieve the choking.  If it is unsuccessful and the older child becomes unresponsive then lay the child down on a hard, flat surface and begin cpr.

The most important times in this event are the identification of choking, the sooner the better, and the call to 911, again the sooner the better.  There are a million things anyone can choke on and our homes are where most of the action takes place so please take a little time and do some prevention work around our homes and as always, I recommend taking an official American Heart Association CPR class in your area that will cover the CPR and choking (click here to find a course) and give you ample practice time so you can be better prepared.

Thank you and be safe.

About the Author

Greg Atwood is a Firefighter /Paramedic in Coral Gables Florida and works for the Coral Gables Fire Rescue. He is an American Heart Association certified instructor in BLS ( Basic Life Support ), ACLS ( Advanced Cardiopulmonary Life Support ), and PALS ( Pediatric Advanced Life Support ). Greg currently lives in Miami Florida with his beautiful wife Alexa and their 2 sons, Connor and Jake. Greg is a member of the PedSafe Expert team

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