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Heimlich maneuver in the unconscious child
Choking in an unconscious child may occur when the upper airway, usually the throat or windpipe, is blocked by an object or irritation. A child for the purposes of this article is 1 to 8 years old.
What are the signs and symptoms of the injury?
Signs and symptoms of choking in an unconscious child include:
What are the causes and risks of the injury?
- lack of breathing
- inability to move air in and out of the lungs, even with assistance
Choking is usually caused by objects that the child has placed in his or her mouth. These include toys, candy, popcorn, hot dogs, nuts, batteries, rocks, and buttons. Things that wrap around the neck and constrict it, such as strings or rope, can also cause choking.
What can be done to prevent the injury?
Some cases of choking can be avoided by:
How is the injury diagnosed?
- giving young children only age-appropriate toys
- avoiding toys that break easily, have small parts, or have batteries
- keeping foods such as popcorn, hot dogs, nuts, and seeds away from small children
- keeping buttons, watch batteries, coins, rocks, and any other small household items away from little children
- keeping strings and ropes away from small children. Never tie a pacifier with string to a child's clothing. The string could get wrapped around the child's neck.
A child who is unconscious due to choking will be unresponsive. The rescuer will be unable to push air into the lungs with mouth-to-mouth breathing. Bystanders may report an episode of choking, followed by unconsciousness.
What are the treatments for the injury?
First aid for an unconscious child who has choked includes:
What are the side effects of the treatments?
- checking for signs of circulation, such as normal breathing, coughing, or movement in response to stimulation
- contacting the emergency medical system immediately
- opening the child's mouth by grasping the tongue and lower jaw between your thumb and fingers and lifting. Only if you see the object should you gently sweep your index finger in a hooking motion deeply into the child's mouth to remove it.
- starting cardiopulmonary resuscitation, or CPR, if the child has no signs of circulation. Use 5 chest compressions for every 1 mouth-to-mouth rescue breath.
- placing the child in a side-lying position if he or she starts breathingand monitoring closely
- staying with the child until medical help arrives
The chest compressions of CPR can cause vomiting, injuries to internal organs, or broken ribs. Vomiting can be a problem if the vomit is caught in the airway and inhaled into the lungs. None of the procedures may work, and the child may still choke, remain unconscious, or possibly die.
What happens after treatment for the injury?
Anytime a child chokes, medical attention should be sought since the object may have been inhaled into the lung. This can cause wheezing, persistent cough, or pneumonia.
Author: James Broomfield, MD
Reviewer: Eileen McLaughlin, RN, BSN
Last Updated: 12/08/00
Potential conflict of interest information for reviewers available on request