Clearing a conscious casualty's airway obstruction can be performed
with the casualty either standing or sitting, and by following
a relatively simple procedure.
WARNING
Once an obstructed airway occurs, the brain will develop an
oxygen deficiency resulting
in unconsciousness. Death will follow
rapidly if prompt action is not taken.
| a. Step ONE. Ask the casualty
if he can speak or if he is choking. Check for the universal choking
sign (Figure 2-18).
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| b. Step TWO. If the casualty
can speak, encourage him to attempt to cough; the casualty still
has a good air exchange. If he is able to speak or cough
effectively, DO NOT interfere with his attempts to expel the obstruction.
c. Step THREE. Listen for high pitched sounds when the
casualty breathes or coughs (poor air exchange). If there is poor
air exchange or no breathing, CALL for HELP and
immediately deliver manual thrusts (either an abdominal or chest
thrust). |
NOTE
The manual thrust with the hands centered between the waist and the rib cage is
called
an abdominal thrust (or Heimlich maneuver). The chest thrust
(the hands are centered in
the middle of the breastbone) is used
only for an individual in the advanced stages of
pregnancy, in
the markedly obese casualty, or if there is a significant abdominal
wound.
- Apply ABDOMINAL THRUSTS using the procedures
below:
o Stand behind the casualty and wrap your arms around his waist.
o Make a fist with one hand and grasp it with the other. The
thumb side of your fist should be against the casualty's abdomen,
in the midline and slightly above the casualty's navel, but well
below the tip of the breastbone (Figure 2-19).
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o Press the fists into the abdomen with a quick backward and
upward thrust (Figure 2-20).
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o Each thrust should be a separate and distinct movement.
*NOTE
Continue performing abdominal thrusts until the obstruction is expelled or the casualty
becomes unconscious.
o If the casualty becomes unconscious, call for help as you
proceed with steps to open the airway and perform rescue breathing.
See task 081-831-1042, Perform Mouth-to-Mouth Resuscitation.)
- Applying CHEST THRUSTS. An alternate technique
to the abdominal thrust is the chest thrust. This technique is
useful when the casualty has an abdominal wound, when the casualty
is pregnant, or when the casualty is so large that you cannot
wrap your arms around the abdomen. To apply chest thrusts with
casualty sitting or standing:
o Stand behind the casualty and wrap your arms around his chest
with your arms under his armpits.
o Make a fist with one hand and place the thumb side of the
fist in the middle of the breastbone (take care to avoid the tip
of the breastbone and the margins of the ribs).
o Grasp the fist with the other hand and exert thrusts (Figure 2-21). |
o Each thrust should be delivered slowly, distinctly, and with
the intent of relieving
the obstruction.
o Perform chest thrusts until the obstruction is expelled or
the casualty becomes unconscious.
o If the casualty becomes unconscious, call for help as you
proceed with steps to open the airway and perform rescue breathing.
(See task 081-831-1042, Perform Mouth-to-Mouth Resuscitation.)
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