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) Perform abdominal thrust - Stand behind the injured and give 5 back blows using the heel of one hand.
(2) After the back blows, remain standing behind the injured. Make a fist with one hand with the thumb facing towards the injured and place it on the upper abdomen of the injured (2.5 cm above the navel). Grasp the fist with the other hand and thrust inward and upward for 5 times.
(3) Repeat the above steps until the foreign body is expelled.
If the injured is unconscious
(1) Call for help, lay the injured flat on his/her back, and perform CPR immediately.
(2) During rescue breathing, check the injured’s mouth for any expelled foreign body.
(3) If the objects cannot be removed, continue to perform CPR.
If the injured is an infant
(1) Support the infant's jaw with one hand, turn him/her to a face-down position. Lay the infant prone on your forearm and support his/her body on your thigh.
(2) Slap the infant between his/her 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 over and give 5 quick chest thrusts with the heel of one hand.
(4) Alternate between back blows and chest thrusts, until the foreign object is expelled.
(5) (Compression site: sternum below the nipple line, i.e. lower half of the sternum.)
If the injured is very fat or a pregnant woman
(1) Stand behind the injured wand give 5 back blows with the heel of one palm.
(2) After the back blows, remain standing behind the injured. Make a fist and place it on the central part of his/her chest. Cover the fist with the other hand and give 5 quick chest thrusts.
(3) Repeat the above steps until the foreign body is removed.
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