Airway obstruction
Introduction
It means difficulty in or cessation of breathing. When our airway is obstructed, our bodily tissues will lack oxygen. The brain and the heart will be affected and eventually the heart will stop beating. Any delay in treatment and rescue will result in irreversible damage to brain cells and ending in the death of the injured.
Causes
(1) The mouth and the nose are blocked.
(2) The airway is obstructed by foreign bodies such as food, vomit, blood, spit, foreign particulars or the dropping tongue.
(3) The neck is strangled when it is, for example, hanged or squeezed.
(4) Airway spasm: it may occur when one is drowned.
(5) Airway oedema: it may result from asthma, smoke inhalation or burns.
Clinical Features
(1) Difficulty in breathing
(2) Irregular heartbeat
(3) Congestion of neck veins
(4) Cyanosis
(5) Coma
Treatment
The principle is to maintain an opened air passage.
Tongue Dropping
(1) Lay the injured down on his back. Tilt his head to let his tongue resume its normal position.
(2) When the injured’s breathing is restored, place him in a recovery position.
Choking
(1) Vomit, blood or spit- Wipe it out with a finger or use an aspirator.
(2) Food or foreign objects- Carry out the abdominal thrust.
If the injured is conscious
(1) Use the abdominal thrust- Stand behind the injured with your arms around his abdomen. Clench one fist. Grasp the clenched fist with the other hand and place it on the injured’s upper abdomen (2.5cm above the navel). Press the fist against the injured’s abdomen with a quick upward thrust 5 times.
(2) Remove foreign bodies from the injured’s mouth.
(3) Observe the injured’s consciousness level.
(4) It unsuccessful, repeat the abdominal thrust.
If the injured is unconscious
(1) Call for help. Perform CPR immediately and observe the injured’s mouth.
(2) Remove any loose objects from the injured’s mouth.
(3) If the objects cannot be removed, continue to perform CPR.
If the injured is an infant
(1) Lay the infant prone on your forearm. Support its body with a thigh and grip its lower jaw with a hand to make its head down.
(2) Slap the infant between its shoulder blades 5 times with the heel of the other hand. The strength should not be as strong as that used on an adult.
(3) If unsuccessful, turn the infant and press its chest with a quick thrust five times. (Compression site: Just below the cross formed by of the sternum and the imaginary line between the nipples.)
If the injured is very fat or a pregnant woman
(1) Stand behind the injured with your fist on the central part of his/her chest. Grasp the fist with the other hand and press his/her chest with a quick thrust five times.
(2) If unsuccessful, stand behind the injured. Support his/her chest with one hand and slap him/her between the shoulder blades five times with the heel of the other hand.
Cardiopulmonary Resuscitation (CPR)
If the breathing and heartbeat of an adult patient stop immediately help him resume breathing and maintain his heartbeat to avoid oxygen depletion in his brain.
CPR Procedure: Check for response and breathing> No response and not breathing> Ask for Help> Chest Compression and Rescue Breathing (ratio 30:2)> Continue CPR until Ambulance crew take over or victim starts to move