When my daughter was five years old, she choked on a lollipop. In what were the scariest few minutes of my life, I tried to do the Heimlich manoeuvre a few times and failed. I then ran out the back door, holding my daughter and screaming for my neighbour, who is an emergency room doctor. Luckily, she heard me, ran over and saved my daughter’s life. As a family, we now take the possibility of choking much more seriously. Believe me: It can happen in a split second, and if it does, you’ll want to be prepared.
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Prevention: We’ve all heard we should cut up our kids' grapes and not leave small toys lying around the house. While this is solid advice, Valerie Wood, founder of ERT Emergency Response Training and a Canadian Red Cross Training Partner who conducts baby and infant first aid and CPR courses in Ontario, says, actually, the best way to prevent choking is to have your child sit down at a table while she eats. “Kids have a hard time concentrating on two things at once. They shouldn’t watch TV and eat, or walk around and eat.” She encourages you to always sit with your children while they’re eating so you can see their faces. “It takes approximately 60 seconds to choke to death. And choking is silent.”
Read more: Tips to prevent choking>
The signs: If you think your child might be choking, ask him a question or try to get him to talk. If no noise comes out, or only a high-pitched sucking sound, there is likely something lodged in his airway. (If he is able to cough, encourage him to do so to try to get the object out.) If the airway is cut off, a child’s face will first turn red, and then blue if the oxygen is cut off completely.
What to do: If your child is at least one year old, see illustrated steps below. If he is younger: Position yourself low to the ground and support his head and neck. Hold him face down on your forearm with his head toward the ground and, using the heel of your hand, hit him five times sharply between the shoulder blades. Flip him over and, using two fingers, press down forcefully on the breastbone five times (go to redcross.ca for illustrated steps). “Repeat this until he starts to cry, which would indicate the object is out of the airway,” says Wood. If your child becomes unconscious follow the steps below.
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When to call 9-1-1: If there is someone with you, have him call 9-1-1 whenever you think your child’s life is in danger, says Wood. But every second counts, and if you’re on your own, you don’t want to take time away from trying to save your child, so start and repeat the techniques before calling. If you are unsuccessful and your child has become unconscious, do CPR—30 chest compressions and two breaths—repeatedly for two minutes (five cycles) before stopping to call 9-1-1. “Those first two minutes are vital for potentially dislodging the object and opening the child’s airway,” says Wood. (If you don’t know CPR, call 9-1-1 once your child has fallen unconscious.) Wood urges all parents to take a first aid course that covers infant and child choking and CPR. “It could be the difference between life and death.”
For children ages one and older, follow these steps (it's a good idea to role-play in a non-emergency situation, so your child doesn't resist you when it counts):
If she cannot speak, cough or breathe, or is making high-pitched noises, it is severe choking. (For mild choking, encourage her to cough to clear the obstruction.)
Read more: Choking cautions>
For severe choking, bend her over, wrap an arm around her chest and with the other, give five sharp blows between the shoulder blades with the heel of your hand.
Bring her upright and, kneeling behind her, place a fist above her belly button, cover with your other hand, and do five sharp inward and upward thrusts. Repeat step 2 and 3 until she begins to breathe or cough.
A version of this article appeared in our November 2014 with the headline "Is she choking?", p. 24.