First Aid for Babies and Kids - Michelle's Response

Mum Zone's resident First Aid for Babies and Kids Expert Michelle of Little Aid is available to answer some of your questions.

Topics include: All basic first aid areas especially those related to babies and children (eg. CPR, choking, drowning, burns and scalds, fevers, seizures, poisons, head injuries, asthma, bites and stings and more), plus issues such as calling an ambulance, using a phone during an emergency, keeping safe and staying calm during an emergency, accidents and how to handle them, etc.

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Reader's Question

What do I do if my 5 year old is choking? My first reaction would be to whack his back in between the shoulder blades but I hear you should not do that?

Michelle's Response

What a great question! The short answer is it depends on the type of choking you're talking about, it can be either a yes or a no.

There are two types of choking:

1. Partial airway obstruction:

Description - airway is partly blocked allowing some air to get through (such as water "going down the wrong way".)

Signs/symptoms - the patient will cough, may wheeze, and may even vomit. Their face may go red and eyes may water.

Treatment - Nothing! If the patient is coughing, they're breathing, though admittedly not comfortably. Ensure the patient is not laying down (or hold baby up on your lap or upright over your shoulder.) Do NOT give back blows (hit the back) for a partial airway obstructions as this may lodge the object down further and interferes with coughing. Remember that coughing is the patient's best defence, this is the gag reflex working, and it works brilliantly! Babies and children have a particularly good gag reflex (just check out how often they vomit!)

2. Full airway obstruction:

Description - airway is completely blocked, no air can get through.

Signs/symptoms - very silent, face changes colour rapidly from red, to purple and even blue. May show body language of trying to cough such as tongue sticking out, bulging eyes and thrusting their head forward.

Treatment - Firstly, remain calm. Secondly, call 000. Finally, treat the patient whilst the ambulance is on the way. The treatment is best demonstrated in person; like CPR, this requires training with manikins but I'll do my best to describe the treatment, and I suggest reading this with a cushion or teddy in your hand to do the actions as you're reading them, and I'll explain the treatment for a baby or toddler first, before explaining the variations for a child:

1. Have the baby or toddler over your lap, laying with their head down (support their jaw) approximately 45-degrees lower then their bottom. This is harder then it sounds but allow gravity to help!
2. Using the palm of your other hand, you need to firmly hit the patient between the shoulder blades BUT it is essential to have the technique correct so we don't hurt the patient. (Do NOT use the ‘heel' of your hand, the part closest to your wrist as this is too hard and you could do damage for a baby or toddler.)
3. In a swooping motion, like the shape of a big U, start with your hand up over the patient, hit between the shoulder blades, and finish with this hand in the air. The swoop motion is called a "back blow" and should be done in the direction toward the patient's head (careful not to hit the head.)
4. Check for an object in their mouth not in the throat! This pause will also allow the patient to begin coughing if they now can. (If they cough, you stop, but leaving them in this position for a few moments.)
5. Repeat up to 5 back blows, pausing in between for around 1-2 seconds.
6. If no object is dislodged, begin on 5 chest thrusts:
7. Keeping the patient in the same position over your lap, supporting their head and with your lower palm/wrist at their chest. Your other hand now rests flat on their back.
8. With equal force with both hands, thrust (do not squeeze) in a short, sharp action. This is almost like trying to get the patient to cough. This is not a hitting motion, both hands are touching the patient at all times.
9. Again, pause and check in the mouth not down the throat for an object between each thrust. And again, stop if the patient coughs or vomits and keep them in this position for a few moments.
10. Repeat 5 x back-blows, 5 x chest-thrusts until the object is dislodged or the ambulance arrives.
11. Should the patient become unconscious, commence CPR .

For an older child such as your 5-year-old the rules are the same, however the patient will be standing rather then laying over your lap. For a full airway obstruction, it is preferable that the patient leans forward at a 45-degree angle with their hands on an object for support (eg, a chair). Stand side-on with one hand on the patient's belly button NOT behind them. Using the heel of your other hand (it's okay to use the heel for an older child) in the same swooping motion, give up to 5 back blows between the shoulder blades, pausing in between. If not successful, do 5 x chest thrusts using the heel of your hands directly opposite each other, one on the child's upper chest and one between the shoulder blades. Repeat steps 9, 10 & 11. (This also works for adults.)

*** An important note - staying calm in a situation like this is not easy, but panic is the worst enemy of choking. A baby or toddler will feel discomfort but won't know to panic unless they read that into your own reaction. Talk positively ("it's okay, I know what to do, good boy...") out loud as this helps more then you realise, both for you and your child. An older child will most likely panic themselves if they are choking so your words of reassurance help immensely. The treatment for choking is extremely successful if we don't allow too much panic to interfere.

And yes, I've done this with my own children and it's worked! :-)

*Editor's Note: Tip - print this page up and keep it somewhere safe in case you ever need it!

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The opinions expressed on these pages are of a general nature and are by no means a substitute for professional advice. Therefore neither Mum Zone or Michelle Fiddian of Little Aid are liable for any actions pertaining to the use of the supplied information.