How to deal with foreign body obstruction in the trachea? Heimlich First Aid saves lives

"Scissors, rocks, cloth" refers not only to the game we played as children, but also to save lives. 

"Scissors - two fingers on the navel; stone - hold the fist with your hand until it stops on two fingers; Cloth - wrap the "stone" with one hand and hit it back and forth five times quickly until the patient vomits out the object. This is the Heimlich First Aid (quick pressure on the abdomen). The Heimlich Method is a three-step emergency first aid method invented by Mr. Heimlich, an American doctor.

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It was first used by Dr. Heimlich in 1974 to save a patient who had choked on food, and since then it has been widely used around the world as the "embrace of life." Mastering this method can save a life in seconds. This is a simple action used to push food or other foreign objects out of the airway by increasing pressure on the abdomen and chest during suffocation.

In case of tracheal foreign body blockage, the specific measures are as follows

1. Determine whether you really suffocate.

People who are suffocated usually put their hands around their necks, or struggle desperately, and their expressions are panicked. The airways are completely blocked (no air enters their lungs), so they cannot breathe and speak. The main causes of choking include food, external trauma, or respiratory edema caused by severe internal allergic reactions.

2. Keep the suffocating person in a standing position.

If the suffocator is too heavy, or in a limited space like an airplane, they can also sit upright, as long as there is enough room for action to perform the action.

3. Before using the Heimlich First Aid method on the person who has choked, hit the back with one hand between the suffocated shoulder blades. If there is no improvement, start rapid abdominal compressions immediately. Be careful, however, not to back someone whose airway is only partially blocked, as this may make the blockage deeper.

4. Stand behind the suffocator.

If the asphyxiated person faints, faints or loses consciousness, spread his legs apart to form the shape of a tripod. surround the suffocating person from behind, place your hand from behind the abdomen (stomach) of the suffocating person, use your dominant hand for the first time (the dominant hand in daily life and work, most people's dominant hand is the right hand), the fist where the thumb of the dominant hand should be closed, this fist is placed below the sternum above the suffocating person's navel; Squeeze the dominant hand with the other hand and make sure the rescuer's thumb is away from the suffocator to avoid injury.

Implementation of the Heimlich First Aid Act

Press inward and upward, quickly and upward against the abdomen of the asphyxiated person, using force. The course of action is similar to "J" -- inward and upward. The squeeze should develop quickly and forcefully, as if you were pulling the suffocator off the ground. Perform 5 abdominal compressions in quick succession. Repeat this until the foreign body is expelled.

If first aid is effective, the person who has choking coughs up blockages in the airway. If the foreign body is not successfully discharged, seek help immediately. If the asphyxiated person is unconscious, stop pressing. Call the emergency number for emergency help. If possible, let someone else do it to save time.

Clean the airway of the person who has choking (check the mouth to see if any visible foreign bodies can be removed) and perform rescue breaths or chest compressions (CPR). Continuous care for asphyxia.

Asphyxiation can be life-threatening, asphyxiating people can die at any time, and efforts to keep the airway open enough can increase their chances of rescue.

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Find different first aid methods according to different situations

Rescue of babies

Place the baby face up on a hard flat surface with the rescuer kneeling at or standing on the baby's feet, or the rescuer sitting in a chair with the baby facing out on the knee and holding it in place. 

Place the index and middle fingers of both hands on the baby's upper abdomen (under the rib arch, above the navel) and press quickly upwards with your fingers, but gently until the object causing suffocation is expelled.

Self-rescue

1. Clench a fist with one hand pressed sideways against the abdomen (below the rib arch and above the navel). Grasp the clenched hand with your other hand and squeeze quickly upwards. Repeat this step until the obstruction is drained.

2. Rely on a fixed horizontal object (such as the edge of a table, chair, armrest, etc.), use the edge of the object to apply pressure to the upper abdomen, produce a strong upward impact, and repeatedly compress until the object causes suffocation and discharge.

Deliverance for the unconscious

Lay the rescued person flat, face the rescued, bend his knees and ride lightly on the rescued person's hip. Overlap your hands, place the base of your palms on the upper abdomen of the rescued person, and use the weight of your body to quickly squeeze the abdomen upwards, repeating until the suffocating object is finally discharged.

Cardiac arrest

Chest compressions are an important out-of-hospital rescue method that can help people who do not have cardiac arrest return to their normal heart rate. When administering this method to patients with cardiac arrest, the following are common considerations:

1. Pressing timing

When the effective pumping function of the heart and circulation suddenly stop, chest compressions should be performed as soon as possible. In cardiac arrest, although the heart loses its ability to pump blood effectively, the electrocardiogram and cardiac activity do not stop completely.

2. Patient position

The patient lies on his or her back on a hard bed or on the floor. If it is a soft bed, a wooden board should be placed under it to ensure effective compression. Pressing on the soft plate greatly reduces the pressing effect. But don't delay rescue time in order to find the plank. During CPR, the patient's clothing buckle and belt should be loosened. The patient's head should be appropriately lowered to avoid vomiting returning to the trachea during compression, and also to prevent the head from exceeding the level of the heart and affecting blood flow.

3. Position of the rescuer

The rescuer should be close to the chest side of the patient, in order to ensure that the force acts vertically on the sternum during compression, the rescuer can use different positions such as kneeling or footstool according to the patient's own position.

4. The pressing part should be accurate

The site of compression is located at 1/3 of the substernal junction or the midpoint of the double papillary junction.

Hypothermia: may damage abdominal organs or cause reflux of stomach contents.

Excessive location: may damage large blood vessels; Because there are important blood vessels behind the sternum, such as the aortic arch.

Site not in the midline: may cause complications such as rib fracture, rib and costal cartilage detachment, hemopneumothorax, etc.

5. The pressure should be uniform

According to the latest guidelines, adults can perform compressions to a depth of 5-6cm. The compression time frequency is 100-120 times per minute. The pressure should be rhythmic, and the frequency should not be fast or slow. At the same time, do not press hard, it is not uncommon to press the ribs "pop".

6. The pressing posture should be correct

Pay attention to the elbows extended, shoulders directly above the hands, not tilted to one side or left or right; Fingers should not press on the patient's chest, and the rescuer does not increase pressure when the compression gap is relaxed, allowing the chest wall to fully rebound. But the root of the palm is still placed in the middle and lower half of the sternum, not leaving the chest wall to avoid displacement.

7. Artificial respiration

Cardiac compressions must be combined with rescue breaths. Prior to airway establishment, either single or double CPR CPR, compression: ventilation requirement is 30:2.

8. Observe closely

When pressing, closely observe the condition, reaction and complexion changes to judge the effect.

Effective indicators of chest compressions are:

(1) Carotid pulse and brachial artery systolic blood pressure can be palpated during compression≥ 60 mmHg;

(2) The patient's complexion, lips, nails and skin turned red again;

(3) The patient's pupil dilation becomes smaller again;

(4) spontaneous breathing occurs;

(5) Consciousness is gradually restored, eye movement, eyelash reflex and light reflex can occur, and even hand and foot twitching, and muscle tone can increase.

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