Consider Relief Of Airway Obstruction If:

• choking is seen or strongly suspected
• cough becomes ineffective (loss of sound)
• breathing becomes noisy and high pitched
• inability to cry, loss of consciousness, turns blue

Follow algorithm A,B,C sequentially for removal of foreign body in
airway:

• A. Perform up to 5 Back Blows (see picture)
  • place infant face down over rescuer's forearm
  • support head by holding infant's jaw
  • infant's head is lower than the body
  • deliver up to 5 forceful back blows with heel of hand between infant's shoulder blades
  • Turn Infant on Back Supporting Head and Neck
    • place free hand on infant's back , holding infant's head
    • other hand supports head, neck, jaw, and chest
    • with infant between 2 hands, turn infant on back
    • infant's head is lower thant the body
• B. Perform up to 5 Chest Thrusts (see picture)
  • place 2 finger tips on middle section of chest bone (sternum), one finger breadth below level of nipples
  • depress chest bone 1 inch
  • repeat up to 5 quick times
  • repeat back blows & chest thrusts until object is dislodged or infant loses consciousness
  • If Infant Becomes Unconscious
    • check mouth for foreign objects and remove them only if seen (grasp tongue and jaw between thumb and finger, and lift)
• C. Perform Mouth to Mouth Breathing (see picture)
  • tilt infant's head gently back, with rescuer's hand on forehead (avoid head tilt with head or
    neck trauma-use jaw thrust)
  • place other fingers under jaw at chin, and lift up
  • seal infant's mouth and nose with your mouth
  • deliver 2 breaths, watching infant's chest rise - if chest doesn't rise, reattempt head tilt and mouth to mouth breathing
  • repeat 5 back blows and 5 chest thrusts if mouth to mouth breathing does not work; consider repeat foreign object removal,then repeat breathing, back blows, and chest thrusts
    as necessary

Call EMS or 911 after about 1 minute, then resume medical support.

Disclaimer: Obtain official instruction in Infant -Pediatric Basic Life Support before performing these maneuvers. If choking relieved, do not continue down this protocol. Always see a physician when choking is suspected and/or these maneuvers are performed. Individual clinical correlation is required. Some infants in respiratory distress may not require the maneuvers described in this card. MIS is not responsible for, nor does MIS guarantee the reliability of these maneuvers.