Dispatch: Ambulance 999 respond for the person choking, 123 Main Street
Ambulance 999: Ambulance 999 responding with a crew of three.
Dispatch: Ambulance 999, you are responding for a 51 year old female. Caller states that she is choking, and would like somebody to come perform the Heimlich Maneuver on her.
Ambulance 999: Dispatch, did you say that the CALLER stated SHE was choking?
Dispatch: (with a chuckle): 999, that’s affirmative.
What’s wrong with this scenario?
If you guessed that a choking person cannot speak, you are correct.
Choking occurs when trachea, which is the airway between the nose/mouth and the lungs, becomes obstructed. And considering the trachea is about the diameter of a McDonald’s straw, you can see that it doesn’t take much to seal off the airway.
In children, 41% of all choking cases are caused by food[1]. But the other 59% of pediatric choking cases are caused by non-food objects. Some major culprits are: buttons, coins, balloons or pieces of balloons, and candy–hard candy, gum, chocolate, gummy bears. In infants, liquid was the number one cause of choking. I have even heard of a child choking to death on a single popcorn kernel. A girl in the local school system choked to death on a cap to a ball point pen.
In adults, the epiglottis (the flap of cartilage behind your tongue that keeps food from entering the trachea) gets fooled or confused when it needs to multitask. (This is why Mom tells you not to talk while you’re eating. Not to mention, nobody wants to see your food while you tell them a story.) The epiglottis can also become “chemically confused,” which is–you guessed it!–caused by drugs or alcohol.
If a person has a full obstruction, they will not be able to make sounds. Which is why you see the 911 dispatcher chuckling in the excerpt above. If they tell you they are choking, they at least have a partial airway.
What should you do if someone has a full obstruction? If an adult or child over the age of one is choking? The first thing you should do is ask him or her if he or she is indeed choking. Just say, “Are you choking?” If they nod or motion that yes, they are choking, the next step is to ask if you can help them. By not asking, you could possibly face assault charges (if you touch somebody without permission, that’s called assault and battery, and nobody wants that. So just say, “Do you want me to help you?” You will probably get a positive response. (In children under the age of 18, consent is implied. Unless the child’s parent is there. If so, you must ask the parent.)
Once you have determined the person is choking and would like your help, turn him or her around so that you are directly behind him/her. Then, locate the belly button, and place your fist, thumb side in, just above the belly button and under the rib cage. Place your other hand on top of your fist and perform a series of abdominal thrusts, pressing your fist inward and upward. This should dislodge the object from the airway.
If the adult or child has a partially obstructed airway, calling 911 is recommended. But abdominal thrusts are NOT recommended until and unless the airway becomes fully compromised.
If and infant under the age of one is choking, and you have the parents’ permission to do so (or if the parents are not present), cradle the baby face down in your arm. Sit down in a chair and rest your arm on your thigh, with the baby’s head down at an angle. Making sure to always support the baby’s head, perform five back slaps, between the shoulder blades. If the item has not become dislodged, gently turn the baby over onto his/her back, and perform five chest compressions, just below the nipple line. Continue alternating five back slaps with five chest compressions until the object becomes dislodged.
If, at any point, the adult, child, or infant becomes unconscious, begin CPR, making sure to check for the object in the mouth rather than giving breaths.
If you ever find yourself choking, you can perform the Heimlich on yourself by bending over the edge of a chair (or table, railing, couch, etc) and performing abdominal thrusts at the same point above your navel and below your ribcage.
By paying attention to children when they eat, and keeping small “chokable” items out of their reach, we can prevent pediatric choking. As for us adults, all we have to do is remember Mom’s rules of not talking while we’re eating and just saying no to drugs and we should be fine.
What ever happened with Ambulance 999 and the talking, choking woman? When the ambulance crew arrived, they found the woman naked, soaking in her bathtub, eating fried chicken. Ah, I love people.
