Choking is the most common module I get asked about in regard to paediatric first aid training. Most parents ask about it because they feel that is the one thing, they are most likely to come up against and they would be right. Babies are fed a diet of mainly liquid (milk and water) in the first months of life. Weaning is the act of introducing solids to the diet and thus to the mouth. The chances of some of this food going array is almost inevitable so knowing what to do in the event of a blockage to the airway is a good piece of information to retain, also helping others if this occurs may be an event which takes place. Anything that gets introduced to the airway that causes a blockage is called a choke, which in turn stops oxygen from reaching the brain. Without oxygen for more than 3-4 mins could cause irreversible brain damage!

Firstly, the history. Have they been eating? Do they have an older sibling who likes to feed them micro blocks? Is there something no longer on the floor that was there a second ago?

You can have a partial or complete choke, but how to recognise it? The partial blockage involves coughing, and if an infant starts to cough and splutter whilst drinking or eating, then the basic survival instinct of the child has kicked in. Give this a chance, often, they will and can clear it themselves. The body is an amazing thing and will protect itself when necessary to a certain extent. Help by leaning them forward and allow them to cough it out.

If, however you don’t hear the coughing and the spluttering, the face goes red then deep purple, the lips go blue or any of the above then this collectively could be a complete blockage. Lean the infant/child* over your arm/lap and administer up to 5 back blows (I mean blow, not pat or slap, it needs to move stuff about a bit!) to the middle of the shoulder blades with them pointing downwards, use gravity to work with you. If this doesn’t work then chest thrusts (infant) or abdominal thrusts (child) are needed, both of which are highly invasive so medical advice should be sought after performing any of those procedures.

If the child goes unconscious, (dial 999 or 112) then you will need to administer CPR and yes, it is worth finding out how to do this. Just In Case. On a lighter note, some parents say that their child has choked before, and they held them upside down, shook** them a bit and banged them on the back… it worked. Not what I would have done but hey, their child is still here with us ok and well, so it worked.

* Infant is a baby aged between birth and 1 year and child is from 1 year to puberty.

** never shake a baby as you could cause severe and irreversible damage to the brain.