Pediatric Emergency: Foreign Bodies In The Airways - First Aid

Emergency in children: Foreign bodies in the airways

Small children are particularly often affected by this emergency, because they like to explore their surroundings with their mouths. Buttons, coins, Lego bricks or even uninflated balloons - objects that are harmless in themselves can obstruct the upper respiratory tract and quickly become dangerous.

Most suffocation accidents occur while guardians are present. It is important to recognize the dangerous situation quickly and to act accordingly.

navigation

• Continue reading
• more on the subject
• Advice, downloads & tools

• How does a foreign body express itself in the airways?
• How can I provide first aid?
• What else is important to know?

How does a foreign body express itself in the airways?

The following signs in children indicate that a foreign body has slipped into the airways (aspiration):

• sudden cough without any signs of infection,
• sudden breathing sounds (such as whistling, rattling, wheezing),
• sudden inability to speak
• Shortness of breath with chest retraction,
• Choke,
• Hoarseness,
• "gasp" for air,
• sudden blue discoloration of the skin.

More on the topic: shortness of breath in children

How can I provide first aid?

Check whether a foreign body is visible in the mouth or throat. If so, try carefully to remove it.

Danger! Do not try to find or remove an object from the throat with your fingers if it is not visible. There is a risk of pushing the object further back.

If the foreign object cannot be removed, do the following

The child coughs but can still breathe adequately:

• Keep the child coughing vigorously.
• If the item cannot be coughed up, call 144.
• Calm the child down and help them breathe calmly and evenly.
• As long as the child can still breathe sufficiently, it should remain upright.

Breathing is restricted or the child is clearly short of breath:

• Immediately dial the emergency number 144.
• Bring the child upside down. If this is not possible with older children, sit them down with the upper body leaning forward.
• Strike 5 times vigorously between the shoulder blades with the flat of the hand.

• If this measure remains unsuccessful:

  • Children over one year of age: Perform 5 compressions of the upper abdomen. You stand the child upright and stand or kneel behind the child. Put both arms around your upper abdomen. Clench your fist and place it between your navel and your chest. Grasp your fist with your other hand and pull firmly inward and upward. Do this up to 5 times!
  • Children under one year of age: Perform 5 chest compressions. Place the child in the head-down position. Find the lower half of the breastbone and press in 5 times forcefully (similar to chest compressions, but at a slower rate.
• If there is no improvement, start again with five hits on the back.
• Repeat the measures alternately until the foreign body can be removed or the emergency services arrive.

The child loses consciousness or is unconscious:

If the child's breathing is so restricted that it loses consciousness, quick action is required:

• Immediately ventilate: Lie the child flat on their back, carefully stretch their head back and ventilate them 5 times.
• If the child remains motionless, start with chest compressions: press 30 times at a frequency of 100 to 120 times per minute.
• If you are alone, repeat the cycle of 2x ventilation and 30x chest compressions 5x and then dial 144. If other people are present, ask them to dial the emergency number while you continue with the resuscitation.

More on the topic: 1x1 first aid for children

What else is important to know?

The compression of the upper abdomen is called the “Heimlich handle”, named after the US doctor Henry J. Heimlich. This measure can cause internal injuries. It is therefore important to have children examined in hospital, even if the measure is successful!

Note Never practice the "Heimlich handle" on healthy people and do not use it on small children under one year of age!

Once a child is passed out, you must start resuscitation immediately, as described above. The pressure during chest compressions and ventilation can push the foreign body out of the airways. Therefore, every time shortly before ventilation, check your mouth to see whether the foreign body is visible and remove it if necessary.

Obstruction of the airway is a very dramatic event. Without first aid, respiratory arrest can be expected in the event of severe airway obstruction. Intervening here immediately saves lives. However, prevention is best. For small children, foods such as nuts, chocolate with nuts, grapes, sweets, beans and larger pieces of fruit pose a significant risk. Small toys (e.g. in surprise eggs) should not be accessible to small children, as should items such as button batteries, coins, marbles, paper clips, hydroponic balls and needles. Uninflated balloons or the pieces if a balloon bursts are also dangerous! They can obstruct the airway, but the risk is often underestimated.