Choking Intervention in Infants and Children
Safety and Efficacy of Back Blows
- The American Heart Association recommends back blows as the standard of care for infant choking, as they avoid the risks associated with abdominal thrusts, which can damage the infant's liver 1, 2
- Back blows delivered to the middle of the back between the shoulder blades do not impact internal organs when performed correctly, according to the American Heart Association guidelines 1, 2
- The technique of back blows involves holding the infant prone along the forearm with the head lower than the chest, which protects vital structures, as recommended by the American Academy of Pediatrics 1, 2
Monitoring and Follow-up
- After a choking incident, verify that the child is breathing comfortably without stridor, wheezing, or increased work of breathing, and check that the child's color is normal, as advised by the American Heart Association 1, 3, 4
- Ensure the child is alert and responsive as usual, and look in the mouth for any visible remaining foreign material, removing it only if clearly visible, as recommended by the American Academy of Pediatrics 1, 2, 3, 4
- Watch for red flags over the next 24 hours, including persistent coughing, gagging, or respiratory distress, stridor or wheezing, refusal to eat or drink, vomiting, and any change in consciousness or unusual lethargy, as warned by the American Heart Association 1, 4
Seeking Medical Evaluation
- Seek immediate medical attention if any respiratory symptoms develop, the child becomes less responsive or lethargic, or if there is uncertainty about whether the entire foreign body was expelled, as recommended by the American Academy of Pediatrics 1, 4
- Even if the child appears completely normal, medical evaluation is warranted if there is any doubt about whether the foreign object was completely expelled, as advised by the American Heart Association 4