FOREIGN OBJECT
AIRWAY
OBSTRUCTION

(CHOKING)

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FOREIGN OBJECT AIRWAY
OBSTRUCTION
Foreign object airway obstruction is the most common
respiratory emergency.
Types of Airway Obstruction
•Anatomical: An anatomical airway obstruction occurs if the airway is
blocked by the tongue or swollen tissues of the mouth or throat.
•Mechanical: A mechanical airway obstruction occurs if the airway is
blocked by a foreign object.

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Incidence
Most common from 1 to 3 years of age;
leading cause of accidental death in
children younger than 1 year of age.
Young children and babies are curious and
like putting objects in their mouths.
Adults may choke on food that has been
inadequately chewed and hurriedly
swallowed.
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Classi cation
1. Partial obstruction: time interval (hours to days) without
symptoms
2. Complete obstruction: emergency situation

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Common Causes of Choking
1. Eating while talking or laughing, or eating too fast.
2. Walking, playing or running with food or objects in the mouth.
3. Trying to swallow large pieces of poorly chewed food.
4. Wearing dentures.
5. Risk factors: Ingestion of foods that can cause asphyxiation
(e.g., hot dogs, round candy, peanuts, grapes, raisins,
popcorn), ingestion of small articles (e.g., coins, parts of toys)

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Clinical ndings
Partial obstruction: persistent respiratory tract infection;
hoarseness or garbled speech; wheeze; stridor
Complete obstruction: substernal retractions; inability to cough
or speak; increased pulse and respiratory rates; cyanosis

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The Universal
Sign for Choking
is hands
clutched to the
throat.
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 If the person doesn't give the Universal
Sign for Choking, look for these indications:
 Inability to talk.
 Di culty breathing or noisy breathing.
 Inability to cough forcefully.
 Skin, lips and nails turning blue (cyanosis) or
dusky.
 Loss of consciousness.

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Management of FBAO/Choking

1. Partial obstruction: no intervention;
allowed to continue coughing until
object is dislodged; if object not
dislodged, call emergency services
(911); prepare child for transport
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Management of FBAO/Choking
• 2. Complete obstruction: immediate rst aid
• a. Infant
1. Turn upside down (head lower than chest)
2. Give up to ve quick, sharp back blows with heel of hand between scapulae
3. Turn over and give up to ve quick chest thrusts using CPR technique
• b. Age 1 year and older: abdominal thrust (Heimlich
maneuver) based on age

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The American Heart Association recommends the Abdominal Thrust (Heimlich
Maneuver) procedures
To perform abdominal thrusts (Heimlich maneuver) on
someone else who is more than 1-Year Old:
1. Check Signs of Choking (e.g. Universal Sign of Chock).
2. Ask “Are you choking, can you speak?”
3. If the victim can’t speak say “I am going to help you.”
4. Stand behind the victim.
5. Wrap your arms around the waist.
6. Tip the victim forward slightly.
7. Make a st with one hand.
8. Position it slightly above the victim’s navel.
9. Grasp the st with the other hand.
10.Press hard into the abdomen with a quick, upward thrust — as if trying to lift the victim
up.
11. Repeat the abdominal thrust till the blocking object is removed (or can be cleared by
hand) or the victim becomes unresponsive.
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 To perform abdominal thrusts (Heimlich maneuver) on
someone else who is INFANT:
1. Note Signs of Choking.
2. A combination of 5 back blows followed by 5 abdominal
thrusts is an e ective way to clear an airway obstruction.
3. Assume a seated position and hold the infant face-down on
your forearm, which is resting on your thigh. Give 5 back
slaps (at 1-second per slap) forcefully between shoulder
blades using heel of hand.
• Note: The combination of gravity and the back blows
should release the blocking object.
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4. If the above doesn't work, hold the
infant face-up on your forearm with the
head lower than the trunk.
5. Give ve quick chest compressions (at 1-
second per compression) using two
ngers placed at just below the nipple line
on the infant's breastbone.
6. Repeat the 5 back blows and 5 chest
thrusts till the blocking object is removed
(or can be cleared by hand) or the victim
becomes unresponsive.
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Notes: If another person is available, have that
person call for help while you perform rst aid.
Begin
doesn't CPR
resume if the airway
breathing. Ifis opened
the victimbut the
becomesvictim
unresponsive
AED, and you
start CPR need to
checkingcall 991
for (activate
foreign EMS),
object get
every time
you open airway to give breaths.
ALERT: NEVER PERFORM
BLIND FINGER SWEEP.
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Always help a conscious choking adult or child
who becomes unconscious to the oor. If you
are (yourself) a choking victim and alone, you
may have to give abdominal thrusts to yourself.
This can be done by
(1) leaning over a rm object and pressing your
abdomen into it, or
(2) making a st and giving yourself quick, upward
thrusts.
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To clear the airway of a pregnant woman or
obese victim:

 Position your hands a little bit higher than with a normal
Heimlich maneuver, at the middle of breastbone’s base, just
above the joining of the lowest ribs.
 Proceed as with the Heimlich maneuver, pressing hard into
the chest, with a quick thrust.
 Repeat until the food or other blockage is dislodged or the
victim becomes unconscious.

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3. Medical removal
by bronchoscopy
4. Surgical relief by
a tracheotomy
below level of
object
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Nursing Interventions
Assessment/Analysis
• 1. Breathing pattern
• 2. Absence of speech
• 3. Color

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Nursing Interventions
Planning/Implementation
1. Teach parents how to prevent aspiration of foreign bodies
• a. Keep small objects such as balloons, buttons, batteries,
coins out of reach; inspect larger toys for removable parts
• b. Avoid o ering
 Hard, smooth foods (e.g., peanuts, raw vegetables) that must be chewed with grinding
motion; mastery achieved at 4 years of age
 Round, rm foods (e.g., hot dogs, carrot sticks); cutor break food into bite-sized pieces
2. Encourage parents to teach children not to run or laugh with
food or uid in mouth and to chew food well before swallowing
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Nursing Interventions
Evaluation/Outcomes
1. Regains a patent airway
2. Child and parents verbalize ways to prevent future airway
obstruction

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