Breathing Emergencies
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Breathing Emergencies

How to act fast when your baby or child is in distress.

Seeing a child choking is frightening for all parents. To quickly decide on the best course of action, first determine if your child is able to breathe. If he can breathe, cry or talk, call your doctor for advice. If your child can't breathe at all, follow the age-specific instructions below to dislodge the object and call 911. The American Academy of Pediatrics strongly recommends that all parents and caregivers take a course in CPR and treatment for choking. Here is some basic advice.

Helping a choking infant

To dislodge an object that an infant is choking on:

  • Place your baby face-down on your forearm in a head-down position. Support your arm with your body.
  • With the heel of your hand, give five blows between the shoulder blades.
  • If she still cannot breath, turn your baby on her back and rest her on a firm surface.
  • Give five rapid chest thrusts with your middle and ring fingers.
  • If she is still not breathing, open the airway using the tongue-jaw lift technique drawing the tongue away from the back of the throat.
  • If you see the object, sweep it out with your finger.
  • If she doesn't start breathing on her own, try to start her breathing by giving two breaths by mouth-to-mouth-and-nose technique. (See infant CPR)
  • Continue to repeat steps 1 to 6 as you call for emergency medical help.

If, at any point, your child loses consciousness, begin CPR.

To perform infant CPR

  • Determine if your baby is breathing by listening for breath sounds, watching the chest and abdomen to see if they are rising and falling, and placing your cheek near your baby's mouth to feel for breath.
  • If your baby is not breathing, open her airway by gently lifting her chin and tilting her head back.
  • Check her mouth for foreign objects. If you can see one, sweep it out with your fingers.
  • Place one hand on the baby's forehead and the other under her chin. Cover her mouth and nose with your mouth.
  • Blow enough air to make chest rise and fall two times.
  • Feel for a pulse. If there is one, give one breath every three seconds. If not, start chest compressions.
  • To perform chest compressions, place your third and forth fingers in center of the chest, half an inch below nipples and press down 1/2-inch to 1 inch at a rate of 100 times per minute.
  • Alternate five fast compressions with one breath.
  • Check for pulse and breathing every minute. If you feel a pulse, stop chest compressions and give one breath every three seconds. If there's no pulse, continue CPR until help arrives.

Helping a choking toddler

To dislodge an object that a child over 1 year is choking on:

  • Place child on her back.
  • Kneel at the child's feet if she is on the floor; stand at her feet if she is on a table.
  • Place the heel of one hand in the center of her body between the navel and the rib cage, your second hand on top of your first.
  • Press into the abdomen with a rapid inward and upward thrust.
  • If the object does not come out, open the child's mouth using the tongue-jaw lift drawing the tongue away from the back of the throat.
  • If you see the object, sweep it out with your finger.
  • If she doesn't start breathing on her own, give mouth-to-mouth resuscitation. (See child CPR.)
  • If unsuccessful, repeat a series of 5 abdominal thrusts.
  • Continue to repeat steps 1 to 6 as you call for emergency medical help.
  • If, at any point, your child loses consciousness, begin CPR.

To perform CPR on a toddler

  • If your child is unresponsive, check to see if she's breathing by listening for breath sounds, watching the chest and abdomen to see if they are rising and falling, and placing your cheek near your child's mouth to feel for breath.
  • If the child is not breathing, open her airway by gently lifting her chin and tilting her head back.
  • Look for any foreign objects that might be in her mouth. If you can see one, sweep it out with your fingers.
  • Place one hand on the child's forehead and the other under her chin. Pinch her nose, and cover her mouth with yours.
  • Blow enough air to make chest rise and fall twice.
  • Feel for a pulse. If there is one, give one breath every three seconds. If not, start chest compressions.
  • To start chest compression, place your hands one finger width above the lower tip of the breastbone. Compress chest 1 to 1 1/2 inches at the rate of 80 times a minute.
  • Alternate fast five compressions with one breath.
  • Check for a pulse and breathing every minute. If you feel a pulse, stop chest compressions and give one breath every three seconds. If there's no pulse, continue CPR until help arrives.

In all cases, if you are alone or have been performing CPR for one minute, call immediately for emergency help. Try to stay clear-headed and remember to give your phone number and address as you attend to your child.

This guide is not meant as a replacement for taking a basic course that teaches CPR and treatment for choking. Contact your local chapter of the American Heart Association or Red Cross to find out where and when certified courses are given in your community.

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