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Assessing and responding to sudden deterioration in the adult
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
What you are attempting to do is to increase the intrathoracic pressure, thus forcing the object out – similar to the effect of coughing. As there is risk of internal damage, the person should always be medically assessed following abdominal thrusts.
Thorax
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
In witnessed choking, where the patient is conscious, they should be encouraged to cough or external manoeuvres (back blows and chest thrusts in infants and abdominal thrusts in adults and older children) are performed to expel the foreign body.
Emergencies, accidents, non-accidental injury and the law
Published in Rachel U Sidwell, Mike A Thomson, Concise Paediatrics, 2020
Rachel U Sidwell, Mike A Thomson
If a child is choking (foreign body aspiration suspected) back blows or chest thrusts are used to dislodge the object in an infant; abdominal thrusts are also used in a child 1 year old. (A finger sweep in the mouth used in adults is not recommended in children as the soft palate can easily be damaged or foreign bodies can be forced further down the airway.)
Incarcerated diaphragmatic hernia following Heimlich maneuver
Published in Baylor University Medical Center Proceedings, 2018
Tiffany Truong, Kevin Salire, Ignacio De Cicco, Sujit Cherian, Gabriel Aisenberg
The Australian Resuscitation Council does not recommend abdominal thrusts at all due to the potential severity of the complications and instead advocates the use of back blows followed by up to five anterior chest thrusts. Anterior chest thrusts are similar to chest compressions but with greater impulse. Another proposed technique is the lateral chest thrust, performed with patients lying on their side. These maneuvers have been infrequently compared through animal and cadaver studies, with mixed results.21,22 Given the public familiarity with HM, it is important to bear in mind potential complications that could ensue in the following minutes to days, as the timely diagnosis of these complications could lead to life-saving treatment.20
Prehospital Pediatric Respiratory Distress and Airway Management Training and Education: An NAEMSP Position Statement and Resource Document
Published in Prehospital Emergency Care, 2022
John Lyng, Matthew Harris, Maria Mandt, Brian Moore, Toni Gross, Marianne Gausche-Hill, J. Joelle Donofrio-Odmann
EMS clinicians should be educated to intervene in pediatric patients with upper airway disturbances first with simple measures such as improving laminar airway flow by helping calm the patient. Then, as necessary and following a stepwise approach utilizing increasingly invasive interventions, the EMS clinician should progress to using medications such as inhaled epinephrine, intramuscular epinephrine, or steroids, and possibly ending with invasive procedures (19, 20). A caveat to this stepwise approach to treating upper airway disturbances would be immediate progression from abdominal thrusts and back blows to use of Magill forceps to relieve a complete foreign body upper airway obstruction.
Prehospital Pediatric Respiratory Distress and Airway Management Interventions: An NAEMSP Position Statement and Resource Document
Published in Prehospital Emergency Care, 2022
Matthew Harris, John W. Lyng, Maria Mandt, Brian Moore, Toni Gross, Marianne Gausche-Hill, J. Joelle Donofrio-Odmann
In the case of foreign body airway obstruction, Magill Forceps are the only rescue option if chest or abdominal thrusts fail. As a result, the value in obtaining and maintaining proficiency in this skillset by advanced EMS clinicians justifies provision of initial and ongoing psychomotor training (94, 95). Use of cadaveric and computer simulation models have been demonstrated as effective in establishing both initial and ongoing competency in these procedures among resident physicians and may have utility in the training of EMS clinicians (96, 97).