FIRST AID 2
Airway Emergencies
March 2010
CANADIAN
CANADIANCOAST
COASTGUARD
GUARDAUXILIARY
AUXILIARY- -PACIFIC
PACIFIC
ABCs
• ABC stands for:
Airway
Breathing
Circulation
• This is the Primary Survey
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Airway Emergencies
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Airway Emergencies
• The airway is the passage through which the
air moves from the nose and mouth to the
lungs.
• If anything blocks the airway, the person
chokes and cannot get enough oxygen, and
life is threatened.
• This is an emergency, and you must give first
aid to clear the airway.
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Airway Emergencies
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Causes of Airway Obstruction
• An airway obstruction can occur if the tongue
or swollen tissues of the mouth block the
airway caused by:
1. An injury to the mouth
2. A severe allergic reaction
3. The tongue dropping to the back of the throat
and blocked the airway
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Causes of Choking
• Any airway blockage caused by a foreign
object or fluid is called choking.
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Causes of Choking
1. Trying to swallow large pieces of food.
2. Excess alcohol, causing suppression of the
gag reflex, and then choking on food.
3. Wearing dentures
4. Eating with talking excitedly or laughing or
eating too quickly
5. Walking, playing or with food, small toys or
other objects in the mouth
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Signs and Symptoms of Choking
• A person who is choking may have a partial
or complete blockage of the airway.
• A complete blockage will not allow breathing.
• A partial blockage may be cleared by the
person coughing.
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Signs and Symptoms of Partial
Obstruction
1. High pitched or wheezing sounds when
breathing in
2. Coughing
3. Clutching at the throat with one or both hands
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Signs and Symptoms of
Complete Obstruction
1. May be conscious or unconscious
2. Unable to breathe
3. Unable to speak
4. Unable to cough
5. Face may appear bluish
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Signs and Symptoms of
Complete Obstruction
• A conscious adult can usually indicate they
are choking.
• With an infant or small child who is conscious
but not able to breathe assume they are
choking on something.
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First Aid for Choking
• For a patient with partial airway obstruction
do not interfere with their attempts to cough
up the object.
• If the patient is no longer able to cough or
speak, treat as for complete obstruction.
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First Aid for a Conscious Choking
Adult with Complete Airway
Obstruction
1. Ask “Are you choking?”
2. Summon someone to help you.
3. Attempt abdominal thrusts - stand behind the
person and wrap your arms around their
waist.
4. Make a fist with one hand and place the
thumb side of the fist on the middle of the
abdomen slightly above the navel.
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First Aid for a Conscious Choking
Adult with Complete Airway
Obstruction
5. Grasp your fist with the other
hand and give quick upward
thrusts into the abdomen to
dislodge the object.
6. Repeat until the choking stops or
they become unconscious
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Abdominal Thrusts for a
Conscious Choking Adult with
Complete Airway Obstruction
• Use chest thrusts when you can’t reach far
enough around the patient, or for women in
late pregnancy
1. Place your arms under the patients armpits
and around the chest.
2. Make a fist with one hand, place the thumb
side against the centre of the patient’s
breastbone.
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Abdominal Thrusts for a
Conscious Choking Adult with
Complete Airway Obstruction
This is not to be the lower tip of the
breast bone and not on the ribs).
3. Grab you fist with the other hand
and thrust inward.
4. Repeat until the object is
dislodged or the patient becomes
unconscious.
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When to Stop Chest Thrusts,
Abdominal Thrusts and Back
Blows
• Stop immediately if the object is dislodged or
if the patient begins to breathe or cough.
• Make sure the object comes out.
• The thrust can cause internal injuries, and
should be seen by EHS.
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First Aid for Conscious Choking
Children with Complete Airway
Obstruction
• The significant difference for
treating a child over the age of 1,
is use less force to expel the
object
• Make sure you are sitting or
stable before starting
• Otherwise use the same method
as an adult
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First Aid for Conscious Choking
Infants with Complete Airway
Obstruction
• First determine if the infant is choking by
observing if the infant can breathe, cough or
cry or is coughing weakly or making high
pitched sounds.
• Do not use abdominal thrusts.
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First Aid for Conscious Choking
Infants with Complete Airway
Obstruction
• Turn the infant face down on your fore arm
with the head lower than the body, and with
the heel of your hand give five forceful back
blows between the infant’s shoulder blades.
• Then turn the infant over, with its head lower
than its body.
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First Aid for Conscious Choking
Infants with Complete Airway
Obstruction
• Give five chest thrusts using your middle and
index fingers on the breast bone one finger
width below the nipple line.
• Repeat back blows and chest thrusts until
object is coughed up or infant becomes
unconscious.
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First Aid for Conscious Choking
Adult Who Becomes Unconscious
• If the obstruction cannot be removed the
casualty may become unconscious.
1. Lower the casualty to the floor on their back.
2. Open the airway and look for an obstruction.
3. If seen, lift the lower jaw, remove the object
by sweeping it out using a hooking action with
your finger.
4. Be careful not to push the object deeper
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First Aid for Conscious Choking
Adult Who Becomes Unconscious
5. Next try to open the airway using head tilt/
chin-lift method
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First Aid for Conscious Choking
Adult Who Becomes Unconscious
6. Assess for effective breathing for 10 seconds.
7. If not breathing attempt to ventilate.
8. If air does not go into the lungs, retilt the
head and try again.
9. If air still does not go into the lungs, assume
the airway is still obstructed and begin the
CPR sequence with 30 chest compressions.
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First Aid for Conscious Choking
Adult Who Becomes Unconscious
10. After those, open the airway and look in the
mouth.
11. If you see an object, remove it.
12. If you cannot get air into the casualty’s
lungs continue the CPR sequence, always
looking in the mouth before the ventilation
attempt. Keep trying to clear the airway.
13. If you see and change in the person’s
condition, stop CPR and reassess the ABCs.
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First Aid for Conscious Choking
Adult Who Becomes Unconscious
14. Once you can breathe air into the casualty’s
lungs, give two rescue breaths.
15. Then complete the primary survey by
checking casualty for signs of circulation and
checking and caring for severe bleeding.
16. If there are no signs of circulation, begin
CPR.
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First Aid for Conscious Choking
Adult Who Becomes Unconscious
17. If the casualty has signs of circulation but is
not breathing on their own, continue rescue
breathing.
• If the casualty starts breathing on their own,
monitor the breathing and circulation,
maintain an open airway, and get to EHS.
• Put the casualty into the recovery position.
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First Aid for an Unconscious
Choking Adult
1. Open the airway and place your ear close to
the person’s mouth, then look, listen and feel
for signs of breathing for 10 seconds.
Look at chest and abdomen for movement
Listen for breathing sounds
Feel for exhaled breath on your cheek
If none of these signs are present the casualty
is not breathing
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First Aid for an Unconscious
Choking Adult
2. Use the head tilt/ chin lift method to open the
airway.
3. Attempt to ventilate.
4. If air does not go into the lungs, re-tilt the
head and try again.
5. If air still does not go into the lungs, assume
the airway is still obstructed and begin the
CPR sequence with 30 chest compressions.
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First Aid for an Unconscious
Choking Adult
6. After those, open the airway and look in the
mouth.
7. If you see an object, remove it.
8. If you cannot get air into the casualty’s lungs
continue the CPR sequence, always looking
in the mouth before the ventilation attempt.
Keep trying to clear the airway.
9. If you see and change in the person’s
condition, stop CPR and reassess the ABCs.
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First Aid for an Unconscious
Choking Adult
10. Once you can breathe air into the casualty’s
lungs, give two rescue breaths.
11. Then complete the primary survey by
checking casualty for signs of circulation and
checking and caring for severe bleeding.
12. If there are no signs of circulation, begin
CPR.
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First Aid for an Unconscious
Choking Child or Infant
First aid for a child under 8 is the same as an
adult with 30 compressions, but only
performed with one hand.
First aid for an infant is the same but with two
fingers.
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Choking Emergencies
Problem
Signals
Care
Casualty conscious
partial obstruction
Coughing forcefully
Encourage casualty to
Can speak and breathe continue coughing
Wheezing
If coughing persists, call
EHS
Casualty conscious
complete obstruction
Coughing weakly
Cannot speak or
breathe
Get help
Begin abdominal thrusts
(back blows and chest
thrusts for infants)
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Choking Emergencies
Problem
Signals
Care
Casualty unconscious
complete obstruction
No breathing
Breaths won’t go in
Call EHS
Begin CPR
Look in casualty’s mouth
for an obstruction after
each cycle of
compressions before
attempting to ventilate
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Head Tilt / Chin Lift
• This can be used to
stop the tongue from
blocking the airway.
• If the airway is blocked
by swollen tissue, this
may not work.
• If air goes in from
rescue breaths, the
airway is clear.
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