How to Assist a Choking Child with the Heimlich Maneuver

Check if the toddler can vocalize. When someone is choking, they're unable to speak due to air blockage. Therefore, if you pose a query to the toddler and they're unable to respond, it may indicate choking.

• The toddler may also clutch their throat if experiencing choking.

Observe for signs of breathing difficulty in the toddler. You might notice they struggle to take breaths or produce unusual sounds while breathing, such as high-pitched noises during inhalation.

Assess for ineffective coughing. The toddler may attempt to expel the obstruction from their throat through coughing, but if their efforts are unsuccessful, their cough will be feeble. A vigorous cough usually indicates that sufficient air is reaching their lungs.

Watch for bluish discoloration. Toddlers experiencing respiratory distress may exhibit bluish or dusky hues on their lips, fingernails, or skin peripheries. However, note that children can tolerate oxygen deprivation better than adults and may not show blue discoloration as rapidly.

Refrain from intervening if the child can communicate. If the child can articulate or breathe adequately, avoid initiating the Heimlich maneuver. The same applies if the child can cough forcefully. Nonetheless, maintain vigilance to ensure symptoms do not deteriorate suddenly.

Confirm the toddler's consciousness. Choking may result in the toddler losing consciousness. Verify their responsiveness by engaging them verbally or stimulating their foot lightly. This information will be essential when contacting emergency services. Proceed to steps for managing unconscious choking if the toddler is unresponsive.

Request assistance to summon emergency services. If others are present, delegate someone to dial 911 or your local emergency hotline. In solitary situations, initiate the Heimlich maneuver first and then contact emergency services.

Seek parental approval prior to performing the Heimlich maneuver.

When dealing with a choking toddler who is not your own, endeavor to obtain consent before administering aid if feasible. If a parent is nearby, swiftly obtain consent, remembering that every moment is crucial in life-saving endeavors. In the absence of immediate consent, take prompt action nonetheless.

• In the United States, Good Samaritan laws in your jurisdiction should offer protection for any reasonable actions taken in good faith to rescue the child.

Incline the child forward at the waist. Instruct the child to lean forward at the waist, providing support by placing your hand beneath their chest.

• To effectively execute this maneuver on a child, you may need to kneel on the ground.
• Do not attempt to manually extract the obstructive object from the child's airway if the child remains conscious. Instead, utilize the Heimlich maneuver to dislodge it.
• Alternatively, positioning the child face-down across your lap may be more practical.

Administer 5 forceful back blows. Utilize the heel of your hand to deliver blows directly between the child's shoulder blades, repeating the action 5 times.

• Ensure these blows possess sufficient force. Although they should be robust, they must not topple the child when supported by you, yet they should be sharp and decisive.
• The American Heart Association does not advocate for back blows during the Heimlich maneuver; abdominal thrusts alone can be effective without them.
• Monitor for any signs of dislodgement of the obstructive object. It may be ejected visibly, or resumption of the child's breathing may indicate success.

Position your closed fist beneath the child’s breastbone. Embrace the child, forming a fist with one hand and positioning it directly above the child's navel, aiming to reach beneath the breastbone. Encase your fist with your other hand.

Elevate your clenched fist upward swiftly. Propel your closed fist upward into the child's abdomen with rapid force. Execute this motion promptly, repeating the action four times or until the obstruction causing the child's choking becomes dislodged.

Place a call to 911 following one application of the maneuver. Upon executing the Heimlich maneuver and in the absence of immediate results, ensure prompt contact with 911 or your local emergency services number if no one else is present. Prompt assistance is essential. If you delegated this task to another individual, verify that they have initiated the emergency call.

Assess the effectiveness of the maneuver. In the event that the initial application of the Heimlich maneuver proves ineffective, alternate between back blows and abdominal thrusts. Persist in this cycle until the obstructive object is expelled, the child resumes normal breathing, or the child loses consciousness.

Position the child on the ground. When the child becomes unconscious, carefully lay them on their back on a flat, firm surface. Ensure the action is gentle.

Immediately contact emergency services. Prioritize calling emergency services without delay. The quicker professional medical assistance is summoned, the better the outcome.

• If someone else is present, request them to dial 911 or your local emergency number. This enables you to commence CPR promptly.
• If you're alone, activate the speaker function on your phone to keep your hands free while aiding the choking toddler.

Conduct a mouth examination. Use your finger to carefully inspect the child's mouth. Gently tilt their head to one side and open their mouth, then visually examine the interior. If you identify a visibly loose object in the child's mouth (and not lodged in their throat), cautiously remove it using your finger. Do not attempt to dislodge or retrieve an object that is lodged in the child’s throat!

• Only attempt to extract the object if it is easily removable; if it is lodged in the child's throat, refrain from attempting to dislodge it, as this may exacerbate the situation.

Administer 2 rescue breaths. Tilt the child's head back to facilitate air passage by elevating the chin. Hold their nose to prevent air leakage. Cover their mouth with yours and deliver two breaths, each lasting approximately one second. Observe their chest to ascertain if it rises. If not, proceed to chest compressions.

• If you encounter difficulty in pinching their nose and covering their mouth simultaneously, consider covering both their nose and mouth with yours.

Perform chest compressions. Identify the correct location by locating where the lower ribs meet. Place your hands approximately 1 inch (2.5 cm) above that point on the child's chest. Stack one hand atop the other, placing them flat on the chest. The heel of your hand should align with the center of the child's chest. Apply pressure to depress the chest by about one-third of its depth, approximately 2 inches (5.1 cm). Strive for a swift pace, aiming for 100 compressions per minute. Count to 30 compressions.

Reassess for any remaining obstruction. Your chest compressions may have dislodged the choking object. Inspect the child's mouth again and use your finger to remove any loose objects. However, refrain from attempting to dislodge the object if it remains stuck. Monitor the child's breathing by observing their chest movements.

Continue CPR until the child resumes breathing or medical assistance arrives. Maintain the cycle of 2 rescue breaths and 30 chest compressions, periodically checking for any obstructions in the mouth. Remember to tilt the child's chin upward for the rescue breaths. Persist in this process until the child's condition improves or professional help arrives to take over.

• Minimize interruptions during CPR to sustain circulation effectively.
• If another individual is present, seek their assistance in performing CPR, as two-person CPR is typically more efficient.

Seek prompt medical attention. Even after the child's recovery, it's imperative to seek medical evaluation. This ensures that there are no lasting effects from the choking incident or CPR administration.

• Consider enrolling in a CPR or first aid course to refine your skills and gain further insight into rescue techniques.