Airway obstruction in children. Medical care for a child

FUNDAMENTALS OF FIRST AID
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Airway obstruction in children. Medical care for a child

Fundamentals of First Aid (OPMP)

The vast majority of deaths due to foreign body aspiration falls on the age of up to 5 years, and in 65% of cases - at the age of up to one year.

The initial tactics for airway obstruction by a foreign body is the same in children and adults:

if the child is unconscious and not breathing, you need to try to free the airways;
if the child is conscious, calm him down and persuade him not to hold back his cough; active interventions are undertaken only when the cough becomes weak, stridor increases, or the child loses consciousness;
Call the emergency team as soon as possible.

Help for infants:

inflict 5 blows on the back (holding the child with his stomach down);
turn the child over and make 5 chest thrusts (at the level of the lower third of the sternum - one finger below the nipples), gently supporting him in a position on his back (the child's head should be below his torso); use of the Heimlich maneuver is not recommended due to the risk of liver rupture;
if a foreign body is visible, it is removed; due to the risk of worsening obstruction, blind digital removal of a foreign body in newborns and infants is contraindicated;
again try to open the airways (raising the chin and throwing back the head of the child) and conduct mechanical ventilation. If the lungs are not ventilated, reposition the head again and try ventilation again. In case of failure of all these measures, repeat the entire cycle from the beginning.

For children of the first years of life. In case of obstruction of the respiratory tract by a foreign body in children older than one year, the sequence and scope of therapeutic measures are the same as in adults, with the exception of blind finger removal of the foreign body:

perform the Heimlich maneuver (up to 5 times), being behind a sitting or standing child;
continue a series of 5 shocks until the foreign body obstruction is removed or until the child loses consciousness;
if the child is unconscious, they put him on his back, release the airways and try to perform mechanical ventilation again (checking if the chest rises), then change the position of the child’s head (checking if this leads to the opening of the airways), after which they perform the reception Heimlich (5 pushes): if a foreign body becomes visible, it is removed; otherwise, the whole cycle is repeated. Airway obstruction in infants may be caused by an infection (eg, epiglottis or false croup). In this case, the tactics are completely different.

Authors: Aizman R.I., Krivoshchekov S.G.

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