Airway Obstruction

Airway Obstruction It means difficulty in or cessation of breathing. When our airway is obstructed, our tissues will lack oxygen. Our brain and heart will be affected and eventually the heart will stop beating. Any delay in treatment and rescue will result in irreversible damage to the brain cells and ending in death. Causes - Mouth & nose are blocked - Airway obstructed by foreign bodies:   Food, vomitus, blood, spittle, foreign particulars or the dropping of the casualty's tongue. - Strangling:   Hanging or squeezing of a person's throat - Airway spasm such as dry drowning. - Airway oedema such as asthma, smoke inhalation. Clinical features - Difficulty in breathing - Irregular heartbeat - Congestion of neck veins - Cyanosis - Coma Treatment The principle is to maintain an opened air passage. (1) Swallowing of the tongue:   (a) Lay the casualty on his back. Tilt his head; his tongue will resume its normal position. (b) When the casualty's breathing is restored, place him in a recovery position. (2) Choking: It means the upper airway is obstructed by a foreign body. Muscle convulsion of the trachea will also cause choking.   (a) Vomiting, blood or spittle.     Wipe it out with a finger or use an aspirator.   (b) Food or Foreign Particulars.     Carry out back slap or abdominal thrust. If the Casualty is Conscious: (1) Use abdominal thrust: The first-aider should: - Stand behind the casualty with your arms around the abdomen. Grasp the fist with the other hand and place it on the upper abdomen (2.5cm above the navel) - Press the fist against the casualty's abdomen with a quick upward thrust 5 times. (2) Remove foreign body from his mouth. (3) Observe patient's conscious level. If the Casualty is Unconscious: (1) Call for help. (2) Lay the casualty supine; place the heel of your hands one on top of the other on the chest to start CPR. Look for an object in the victim’s mouth before inflation. (3) Remove the object from the casualty's mouth. If the Casualty is an Infant: (1) Lay the infant prone to the rescuer's forearm & rest on the thigh, use the hand to grip the lower jaw with the infant's head down. (2) Slap the infant between the shoulder blades 5 times with the heel of your hand slightly. (3) If unsuccessful, turn the infant; press the infant's chest with a quick thrust five times. (Compression site: Just below the cross of the sternum and the imaginary line between the nipples.) If the Casualty is very Fat or a Pregnant Woman: (1) The rescuer stands behind the casualty with your fist around the middle of the chest. Grasp the fist with the other hand and place it on the upper chest; press the chest with a quick thrust five times. (2) If unsuccessful, stand behind the casualty; use one hand to support the casualty's chest; use another hand to slap the casualty between the shoulder blades five times with the heel of your hand.

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Cardiopulmonary Resuscitation (CPR) If an adult patient stops breathing and his heart stops beating, call on others immediately to help him resume breathing and maintain his heartbeat to provide his brain with oxygen. There are three main rules to cardiopulmonary resuscitation: (1) Keep the airway clear; (2) Restore breathing by mouth-to-mouth resuscitation; (3) Maintain blood circulation by external chest compression. A. Keeping The Airway Clear To open the airway, use your index finger and middle finger to lift the casualty's chin forward. Use the other hand to press his forehead downward so that his tongue will move forward to keep the windpipe unobstructed. If there is any foreign body, turn the casualty's head sideways or backward. Use your index finger and middle finger to dredge it out. B. Mouth-To-Mouth Ventilation Remove any obvious obstacle on the casualty's face and loosen any restraint around his neck. Open his airway. Then open your mouth widely and draw a deep breath. Pinch the casualty's nostrils together with your hand and press your lips tightly against his mouth to seal it. Blow air into his lungs until expands. Move away your mouth; draw a breath again and repeat the above steps. After blowing into his mouth twice, check if the carotid pulse is present. If there is pulse but no breathing, continue to apply mouth-to-mouth ventilation at a rate of 5 seconds until the patient resumes breathing. Then place him in a recovery position to provide a free airway. If the heart stops beating, you must apply external chest compression. C. External Chest Compression Lay the patient on his back on a firm surface and kneel beside his chest. Place the heel of your hand on the sternum of his chest. The other hand should be placed on the top of that hand. The fingers of both hands should interlock tightly. Both arms should be straight. Press down the sternum 4 to 5 cm vertically and then relax. This step should be repeated 30 times at a rate of 100 per minute. Then move to the patient's head and clear his airway. Apply mouth-to-mouth ventilation twice. Continue to press the chest 30 times and then apply mouth-to-mouth ventilation twice again. Continue to apply mouth-to-mouth ventilation until the patient is revived.

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