What to do when a child starts to choke

If a baby is choking, lay them on your arm with their head lower than their body, and deliver five back blows between their shoulder blades to help dislodge the object. — KPJ Ampang Puteri Specialist Hospital

The nation was recently shocked by the news of a child's death due to choking on chewy candy. 

This incident reminds us of the importance of awareness regarding first aid in choking situations, especially among children.

When someone is choking, it means that the airway is blocked by an object, preventing oxygen from reaching the brain. 

If oxygen deprivation continues for more than four minutes, brain damage may occur and can even be fatal. 

So, what actions should be taken when facing such a situation?

Firstly, bystanders should remain calm and act immediately.

Those who know first aid should act quickly, while others can assist by calling emergency services at 999.

It is important to recognise the signs of choking in a child. These include:

• Persistent coughing without an obvious reason.
• Difficulty breathing or gasping for air.
• Wheezing sounds similar to asthma patients.
• Panic and clutching the throat.
• Inability to speak clearly or make sounds.
• Face turning blue or losing consciousness.

The steps for first aid varies according to age and the victim's level of consciousness.Panic and clutching the neck is a sign of choking, and those trained in first aid can perform the Heimlich manoeuvre if the child is conscious. — The Hartford Courant

If the victim is an infant under one year of age and is still conscious:

• Lay the baby face down along the rescuer's arm, with the head lower than the body, and hold the baby securely.
• Using the other hand, give five back blows between the baby's shoulder blades.
• Turn the baby onto their back and check if the object has been expelled.If the object is visible, remove it carefully without pushing it further in.
• If the baby continues to show signs of choking, place two fingers in the center of their chest and perform five chest thrusts.
• Repeat back blows and chest thrusts alternately until the object is expelled or the baby becomes unconscious.

If the victim is a child aged one to 12 years and is still conscious:

• Ask if the victim can speak or cough.
• If they can still cough, encourage repeated strong coughing to expel the object.
• If the cough is weak or they cannot cough, deliver five back blows between their shoulder blades with their head positioned lower than their torso (e.g. between the legs).
• If unsuccessful, perform abdominal thrusts (i.e. the Heimlich maneuver) below the navel until the object is expelled.
• If the object is visible in the mouth, remove it carefully without pushing it further in.

ALSO READ: The controversy surrounding the Heimlich manoeuvre

If the victim is unconscious and not breathing:

• Lay the victim on the floor.
• Open the airway using the head tilt-chin lift technique.
• Check the victim's mouth and remove any visible object.
• If the victim is still not breathing after the object is removed, give rescue breaths by blowing into their mouth for one second.
• Observe for any chest movement after the rescue breaths.
• Perform chest compressions if necessary.

The public is encouraged to undergo first aid training as it may help save lives. 

With the right knowledge, individuals can act more confidently and effectively in emergency situations.

Prevention is more important than treatment. 

Ensure that the food given to children is of the appropriate sizes and is chewed properly.

Prevent children from playing or joking while eating. 

The safety of children is the responsibility of the adults around them.

Dr Shahrul Nizam Ahmad Zamzali is a consultant emergency physician. For more information, email [e-mail]. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.