Choking – What is it and what do I do?

Choking – What is it and what do I do?

As little ones start to explore the world around them it is very common for them to do this with their mouth at first. Anything and everything goes to their mouth as they try to get a grasp on what they are dealing with. Whether they are teething and seeking relief or simply discovering hidden gems they’ve found under the TV cabinet that you haven’t been able to locate for a decade- you’ll find it in their mouth; and to add to it the fun no land mammal moves faster than a toddler whose been asked “What’s in your mouth?”…. closely followed by the dog when asked the same question.

What is choking?

Choking is when a foreign object- whether it be food, a toy, a coin or even a chewed up piece of cardboard/plastic because lodged in the airway.

Why are little ones under 4 more at risk?

In addition to using their mouth to explore- their airway is smaller than that of an adult, with other parts of the upper airway (tonsils, tounge etc.) taking up more space relative to the size of that airway. For very little ones they are also learning how to chew and may not be able to differentiate what does and does not belong in the mouth.

At what size is something a risk for choking?

For anyone old enough to remember- anything that fits inside a film canister of an old camera is small enough to pose a choking risk. Kidsafe also has a free “choke check” cylinder that can be downloaded from their website.

What are some of the most common things little ones choke on?

Foods like grapes and hotdogs wedge nicely into the airway of a little person so it is recommended that they are cut vertically before serving them up and encouraging them to remember to chew. Hard lollies, small toys, nuts and popcorn also pose some of the highest risks for choking.

Are there different types of ‘choking’?

Yes, yes and yes. Many people mistake gagging for choking. If you take one thing away remember GAGGING IS GOOD. A lot of well meaning people go to tap the back of a gagging baby when all that is needed is some simple encouragement and “good work”. When they are born they push their tongue forward in hopes of milk however as they develop they begin to pull things backwards in their mouth and there are two ‘tubes’ here. One to the tummy and one to the lungs. In the majority of cases when they realized they’ve gotten it wrong they will gag and thrust the food forward. The gag reflux is an important part of development. If you hear that noise of a gagging baby that is clearing their airway resist the urge to tap their back and simply encourage/praise them as the chewed up food comes back onto the highchair table- which they’ll likely pick up and put straight back in their mouth.

So if it’s not gagging then what is it? When does it become true ‘choking’ and what do I do? Beyond gagging there are two ‘types’ of choking known as partial obstruction and full obstruction. The easiest way to identify which is which, is by asking “Do they have an effective cough?”.

If you can see they are coughing and working hard to dislodge the object simply place them on your knee and encourage them to keep trying to clear the object. If you hit their back at this stage you may risk full obstruction choking. A simple way to encourage a young baby to keep coughing is to cough with them as they are likely to mimic what you are doing. In partial obstruction choking it isn’t uncommon for the child to eventually vomit to dislodge what has been stuck in their airway and they are likely to want a good cuddle after this.

Full obstruction choking is when there is silence or no effective cough, the child may begin to change colour and eventually become pale/blue if the obstruction isn’t dislodged.

This is where they need your help.

If you can see that they aren’t able to cough or hear only silence then use the base of heel of you hand to very firmly hit their back between the shoulder blades. For a young child if you can get their head below their stomach whilst doing this, gravity may assist. You are going to do this five times and check between each back blow to see if the obstruction has dislodged. If after five it hasn’t you need to call 000 (best to keep them on speaker phone). This is followed by five ‘chest thrust’ using a few fingers on a young child between the nipples by turning them over and pushing sharply, again keeping their head lower than their stomach to allow gravity to assist. Check between each thrust to see if the obstruction has dislodged. Continue to alternate between five back bows and 5 chest thrusts. If the infant/child becomes unresponsive you need to start CPR.

We highly recommend taking a paediatric first aid course to have hands on experience learning these skills. BabyEd will be in Mackay in late November and early December delivering courses and we hope to be back in the new year! Reach out to us on our Facebook page ‘BabyEd Australia’ if you’d like to host a course or attend one of our public sessions.

Written by: BabyEd Australia

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