Revised First Aid for the Choking Child

Abstract

Aspiration of a foreign body is a common hazard in infancy and childhood. In the last 5 years, there has been a great effort to educate the public on the prevention of choking due to accidental inhalation of foods or small objects by children. Concomitantly, there has been a campaign to teach the first aid measures essential for evaluation and treatment of choking. LITERATURE REVIEW Much of the existing data on treating the choking child has been anecdotal. In 1981, the Committee on Accident and Poison Prevention of the Amencan Academy of Pediatrics reviewed the available literature; the Committee recommended that a foreign body in the upper airway be considered an immediate threat to life and that such a foreign body required urgent removal.1 In addition, the Committee recognized the effectiveness of natural coughing and recommended that, if a choking child could breathe and was able to speak and/or cough, all maneuvers were unneccessary and potentially dangerous. If the choking child could not breathe, cough, or make a sound, a series of back blows and chest thrusts was recommended. The Committee recommendations resulted in a spirited controversy concerning the most effective management of the choking child.2-6 At the July 1985 National Conference on Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care, the American Heart Association, American College of Cardiology, and the American Red Cross convened a panel on Management of Foreign Body Airway Obstruction to review and revise the past recommendations. The panel recommended use of the abdominal thrust—the Heimlich maneuver—as the exclusive method of treating foreign body airway obstruction for adults and children older than 1 year.