Belfast Telegraph

Saturday 26 July 2014

Choking baby: Not knowing what to do can turn normality into tragedy

Last year’s Easter dinner is one that has stuck firmly in my mind for all the wrong reasons. My family and I were sitting around the table, tucking into lamb, when my then nine-year-old niece suddenly went uncharacteristically very quiet.

It took a few seconds for us to realise that she was choking — completely unable to breathe, cough or speak with her face going redder by the second.

My sister, thankfully a nurse, stood up calmly, then stood her daughter up and gave her a hard blow to the back. A large lump of food flew out and both of them sat back down and calmly continued their lunch.

That horrendous moment of panic — when four other adults at the table sat frozen — has crossed my mind on many occasions since. What if my sister hadn’t been there or if she wasn’t a nurse? Would anyone else have known what to do and what would have happened if we didn’t? It doesn’t bear thinking about any further.

What happened that day is a prime example of how an unremarkable, quiet family occasion can suddenly turn on its head with a medical emergency. It’s also an example of how knowing how to deal with such an event can be the fine line between tragedy and normal life resuming pretty quickly.

Given what had happened at my Easter lunch, the part of the British Heart Foundation Heartstart programme dealing with choking was what resonated with me most. We were all given a life-like mannequin to work with and were presented with a scenario in which we had to help a choking adult, then a child and then, a small baby.

We learned that in all cases, if the casualty is able to speak, cough and breathe, then you should encourage them to keep coughing and do nothing else.

Charlie, the school caretaker who I was helping in my imaginary scenario after he choked on a sweet, was unable to speak or cough but was still conscious. I was taught to stand to his side and slightly behind him while supporting his chest with one hand and leaning him over with the other so that when the sweet hopefully dislodged, it would come out his mouth rather than slip further down his windpipe.

I then gave him five sharp blows to the back, between his shoulder blades and with the heel of my hand.

This did not appear to dislodge the sweet, so I was instructed to commence ‘abdominal thrusts’, what many would know as the Heimlich Manoeuvre.

This involved standing behind the mannequin, wrapping my arms around his waist, making a fist with one hand and placing it thumb-side against the abdomen, along the midline and slightly above the navel.

Grasping my fist with the other hand, I was told to give five quick upward thrusts which should force the obstruction out.

If this doesn’t work, I was told to return to five back blows, and then again to abdominal thrusts until the sweet came out or Charlie fell unconscious, at which stage I would have commenced CPR which I was to learn later in the day.

Minnie was the name of the choking ‘baby’ handed to me.

Cardiac nurse Niall McKenna dropped a small black object into Minnie’s windpipe and taught me to gently turn her over, supporting her head and neck as you would normally do, and place her on my knee with her head down and her bottom up.

Slapping a baby hard on the back is horrible, even a doll one, but this is what you need to do between the shoulder blades, with a flat hand.

When this didn’t work, I was taught to give her five chest thrusts which involves turning the baby around and using two fingers to push inwards and upwards against the baby's breastbone, one finger's breadth below the nipple line.

Thankfully, on the second thrust, the tiny object came flying out, otherwise the cycles of slaps and thrusts would continue.

While this was a difficult scenario to imagine dealing with, we all realised the only thing more frightening than dealing with a choking baby or child is not knowing what to do.

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