Lesson 7: Remove an Airway Obstruction in a Child or Infant
7-4. REMOVE UPPER AIRWAY OBSTRUCTION IN AN UNCONSCIOUS INFANT
The steps given below assume the infant lost consciousness while you were administering rescue thrusts [paragraph 7-3f(2)] or you discovered an airway obstruction while performing rescue breathing [paragraph 6-4c(2)]. If a head or spinal injury is suspected, administer chest thrusts and finger sweeps, but do not administer backblows. The procedures given in the following paragraphs assume that no head or spinal injury is present.
a. Call for Help. Call for help if you have not done so and determine unresponsiveness.
b. Position Infant for Foreign Body Check.
c. Open the Infant's Mouth. Open the infant's mouth using a tongue-jaw lift technique.
d. Remove Any Visible Foreign Matter. If you see any foreign matter in the infant's mouth or throat, remove the obstruction with a finger sweep (paragraph 5-6c). Do not perform a blind finger sweep since this action could force the obstruction deeper into the infant's throat.
e. Check for Breathing. Tilt the infant's head back slightly and lift the infant's chin to open the airway. Look, listen, and feel for signs of breathing (chest or abdomen rising and falling, sounds of breathing, exhaled air blowing on cheek).
f. Administer Two Ventilations. If the infant is not breathing on his own, administer two ventilations using the mouth-to-mouth-and-nose method. Even if the obstruction has not been removed, your efforts may have caused it to shift enough so rescue breathing can now be administered.
g. Evaluate Your Efforts.
h. Call for Help. Call for help again. If a second rescuer is available, have him seek medical assistance.
i. Position Infant for Backblows. Position the infant for backblows using the procedures given in paragraph 7-3b(1) if the casualty is a small infant and in paragraph 7-3b(2) if the casualty is a large infant.
j. Administer Backblows. Administer five backblows by striking the infant on the spine between his shoulder blades with the heel of your free hand. The five blows should be delivered within 3 to 5 seconds.
k. Position Infant for Chest Thrusts. Position the infant for chest thrusts using the procedures given in paragraph 7-3d(1) if the casualty is a small infant and in paragraph 7-3d(2) if the casualty is a large infant.
l. Administer Chest Thrusts. Perform chest thrusts in the manner described in paragraph 7-3e. Continue until the obstruction has been expelled or until you have administered five chest thrusts.
m. Continue Efforts to Expel Obstruction. If the chest thrusts did not expel the object, continue your efforts until the object is expelled or you are ordered to stop by a medical authority. If possible, evacuate the casualty as you continue your efforts.
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