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As we all know babies are entirely different victims/patients. An infant is defined as being more than 28 days and under 1 year old. The first question you want to ask yourself is how do I know if an infant victim is choking? We all have seen an infant suck up his / her cereal or semi liquid vegetable products and then appear to be choking, only to have them blow it out their noses and be back to as near normal as babies can get. One of the first signs of a baby choking would be the sudden intake of air and change in facial color. They are in serious danger from choking if they can’t CRY. They will be kicking and flailing but they won’t be able to cry. As soon as you recognize that they are not able to cry, you must act. Pick the infant up and place them so their back is prominent with their head lower than the rest of their body situated over your outstretched arm with their head in your hand resting on your knee if you are sitting down (see figure 1).
The main thing to remember is to keep the head down and grip the jaw so the infant’s head is secure when you strike them (see figure 2).
Strike the baby between the shoulder blades with 5 short blows of the heel of your hand, but do not let your hand rest on them. Do not slap them. Use the edge of your palm or heel of the hand to deliver a momentary strike to the infant’s back between their shoulder blades. You can locate it by drawing a line where the infant’s arms would come across the chest (see figure 3).
Make sure you hold onto the baby’s jaw to keep his /her head from shaking when you strike them (see figure 4).
If you don’t maintain pressure on the jaw the baby’s head will jerk back and forth when you strike them. Their brains are smaller than their skulls and will slosh around inside their head (shaken baby syndrome) and do great damage to them. Once you have delivered 5 strikes, place your cupped hands over the infant’s head (front and back) hold the arms parallel and turn the baby over with the head still lower than the body so their back rests against your forearm (see figure 4).
Place two fingers pointing towards their chin on their chest and deliver 5 slow chest thrusts, looking in their mouth every time you thrust (see figure 5).
If you see something, place the infant on the table and remove it. Keep on delivering 5 back blows and 5 chest thrusts until the infant either spits up the foreign matter or becomes unresponsive. If the infant becomes unresponsive they will stop kicking and their body will go limp. Immediately place them on a flat hard surface like a table or dressing table and begin chest compressions with two fingers directly below the nipple line (see figure 6).
Every time you go to deliver a breath look and see if you see something, if you do remove it. Remember that the infant’s palate is soft all the way from the front to the back. Try to refrain from entering the baby’s mouth with your fingers pointed up to the palate. Instead crook your finger down to the baby’s jaw and follow the tongue to the back, hook what you feel and pull it straight out (see figure 7).
Attempt to get a breath in by placing your mouth over the baby’s nose and mouth. If it goes in try a second one. If both breaths go in, take 5 seconds and look for signs of recovery. If you don’t see any, continue compressions and breaths for 2 minutes then take the baby in your arms and call 911. In this day and age most of us have cell phones. If you have the cell phone on your person, put it down and call 911 as soon as you realize the baby has become unresponsive. Put the phone down and dial 911 on speaker. When the dispatcher comes on tell them you are doing CPR on an unconscious infant. That way the ambulance and advanced medical care will get there quickly to help you.
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John has been an AHA Instructor Trainer since 1993, and is involved at all levels of CPR science development and the introduction of various CPR enhancement techniques and equipment. Since retiring from the Port Authority in 2000, he has been actively spreading the news of increased effectiveness of improved CPR teaching and training by attending National and Local EMS conferences and presenting at the annual ECCU conference. In addition, he spends a good deal of time teaching AHA CPR and First Aid to doctors, nurses, PCT''s, EMTs, and security personnel in hospitals, doctors and dentists offices, Professional Trainers, gyms, shopping malls and pharmacies in New York and New Jersey. He also volunteers as EMT- BLS IT with the Woodbridge Township Ambulance & Rescue Squad as Chief of Operations and Training Director.
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As we all know babies are entirely different victims/patients. An infant is defined as being more than 28 days and under 1 year old. The first question you want to ask yourself is how do I know if an infant victim is choking? We all have seen an infant suck up his / her cereal or semi liquid vegetable products and then appear to be choking, only to have them blow it out their noses and be back to as near normal as babies can get. One of the first signs of a baby choking would be the sudden intake of air and change in facial color. They are in serious danger from choking if they can’t CRY. They will be kicking and flailing but they won’t be able to cry. As soon as you recognize that they are not able to cry, you must act. Pick the infant up and place them so their back is prominent with their head lower than the rest of their body situated over your outstretched arm with their head in your hand resting on your knee if you are sitting down (see figure 1).
The main thing to remember is to keep the head down and grip the jaw so the infant’s head is secure when you strike them (see figure 2).
Strike the baby between the shoulder blades with 5 short blows of the heel of your hand, but do not let your hand rest on them. Do not slap them. Use the edge of your palm or heel of the hand to deliver a momentary strike to the infant’s back between their shoulder blades. You can locate it by drawing a line where the infant’s arms would come across the chest (see figure 3).
Make sure you hold onto the baby’s jaw to keep his /her head from shaking when you strike them (see figure 4).
If you don’t maintain pressure on the jaw the baby’s head will jerk back and forth when you strike them. Their brains are smaller than their skulls and will slosh around inside their head (shaken baby syndrome) and do great damage to them. Once you have delivered 5 strikes, place your cupped hands over the infant’s head (front and back) hold the arms parallel and turn the baby over with the head still lower than the body so their back rests against your forearm (see figure 4).
Place two fingers pointing towards their chin on their chest and deliver 5 slow chest thrusts, looking in their mouth every time you thrust (see figure 5).
If you see something, place the infant on the table and remove it. Keep on delivering 5 back blows and 5 chest thrusts until the infant either spits up the foreign matter or becomes unresponsive. If the infant becomes unresponsive they will stop kicking and their body will go limp. Immediately place them on a flat hard surface like a table or dressing table and begin chest compressions with two fingers directly below the nipple line (see figure 6).
Every time you go to deliver a breath look and see if you see something, if you do remove it. Remember that the infant’s palate is soft all the way from the front to the back. Try to refrain from entering the baby’s mouth with your fingers pointed up to the palate. Instead crook your finger down to the baby’s jaw and follow the tongue to the back, hook what you feel and pull it straight out (see figure 7).
Attempt to get a breath in by placing your mouth over the baby’s nose and mouth. If it goes in try a second one. If both breaths go in, take 5 seconds and look for signs of recovery. If you don’t see any, continue compressions and breaths for 2 minutes then take the baby in your arms and call 911. In this day and age most of us have cell phones. If you have the cell phone on your person, put it down and call 911 as soon as you realize the baby has become unresponsive. Put the phone down and dial 911 on speaker. When the dispatcher comes on tell them you are doing CPR on an unconscious infant. That way the ambulance and advanced medical care will get there quickly to help you.
Vlad Magdalin
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