Choking or airway obstruction is a medical emergency that happens when a foreign object such as a toy, household item or food obstructs the airway, making it difficult or impossible to breathe.
Unfortunately younger children are at a higher risk of choking- this is because they explore the world around them by putting things in their mouths, they have smaller airways in comparison to adults, they may not have their full set of teeth making chewing more challenging and their reflexes are not always well developed,
Choking is a time critical medical emergency and while it is most parents’ worst nightmare, the good news is that there are multiple things you can do to reduce the risk of choking!
As paramedics with 20 years of combined experience we have seen multiple little lives saved by incredible parents who knew exactly what to do in a choking emergency. And we can teach you these skills too!
Let’s get cracking!
Mild versus severe airway obstruction
Choking’s can be broken down into two categories: a mild or severe airway obstruction and the treatment is different for each.
A mild airway obstruction means that only part of the airway has been blocked by a foreign object and your child is most likely still receiving some oxygen to their lungs.
A severe airway obstruction means that a foreign object has completely blocked your child’s airway and they are unable to get any oxygen.
It’s important to know that a mild airway obstruction can progress into a severe airway obstruction, so you must monitor your child very closely and be ready to upgrade your treatment.
The treatment for a mild and severe airway obstruction is different so it’s important to stay up to date with choking treatment.
How do I tell the difference between a mild and severe airway obstruction?
The main difference between a mild and severe airway obstruction is an effective cough versus an ineffective cough.
An effective cough means just that, a person can cough effectively. An effective cough is usually loud and forceful and can often help dislodge an airway obstruction.
An ineffective cough means a person is unable to cough effectively, they will often be silent, that means they may be unable to talk, cry, or make other sounds.
This image may help you remember how to differentiate a mild or severe airway obstruction.
How do I respond to a mild airway obstruction?
If your child has something stuck in their airway, however they have an effective cough, they are able to make noise and they are not turning blue you can you can assume they have a mild airway obstruction and do the following:
1). Call 000 for an ambulance and place the phone on loudspeaker nearby
2). Encourage your child to continue coughing to help bring up the obstruction naturally
3). Keep your child as calm as possible providing lots of reassurance
4). Monitor closely while waiting for help to arrive
Remember a mild airway obstruction may progress to a severe airway obstruction at any point so monitor symptoms closely and be ready to upgrade your treatment.
So how do I treat a severe airway obstruction?
If your child is unable to cough effectively, cry or make any sounds, you can assume they have a severe airway obstruction and you will need to intervene immediately. They may also appear panicked, they may begin to turn blue and potentially become unresponsive.
This video shows you how to manage a severe airway obstruction in an infant under 1 alternating back blows and chest thrusts until the obstruction is relieved. If a person has choked and they are unresponsive or become unresponsive you should start CPR immediately.
We cover choking first aid and CPR for all ages in all of our courses. You can also download our choking safety guide here which has a choking first aid print out for the fridge.
Can I reduce the risk of choking in babies and children?
You sure can, there are a number of ways you can reduce the risk of choking, here are some things to consider!
1). Know how to prepare food safely for different ages
Food must be prepared differently based on age!
Download the free Solid Starts app which tells you exactly how to safely prepare different foods for different age groups, link here.
Check out legendary Perth based paediatric dietician Dr Kylas mealtime subscription, which provides parents with some seriously awesome information about starting solids, feeding fussy toddlers and navigating school lunchboxes, Link here.
You can also download our choking safety guide here, it documents the top 10 high risk choking foods for kids under 5 as well as a choking first aid. You can even print them out and put them on the fridge to refer to in an emergency as well as give them to your child’s daycare/school or to anyone else who is caring for them.
2). Create a safe eating environment for children
It’s super important to make sure you create a safe eating environment for children, as this can also reduce the risk of choking. There are a few easy ways you can do this.
First of all, make sure children are closely supervised by an adult when eating, remember choking can be silent so you should always be around when they are eating.
When eating make sure your child is seated upright preferably in their highchair or seated at a table for older children.
Children should be stationary when eating. This means no eating while walking, running, playing, being pushed in a pram or while traveling in a car seat.
Don’t give your child food while they are crying as they wont be able to chew or swallow properly and may inhale quickly pulling foreign objects into the airway or lungs.
And never force food into your child’s mouth when it is clear they are not interested.
3). Baby/child proof your home
Shockingly children can choke on anything smaller than the size of a 20 cent piece!
When baby proofing, consider items such as coins, pen lids, marbles, burst balloons, batteries, magnets, buttons, needles, safety pins and beads (including polystyrene beans from bean bags which can be inhaled into the lungs). These are all common household choking items.
Create a play pen or a ‘safe space’ to leave little ones briefly when you can not directly supervise them (and so you can use the toilet in peace IYKYK).
When purchasing new toys, always look at age recommendations and ensure you keep older children’s toys such as lego (and other small items) out of reach of younger children.
4). Know first aid
When choking first aid is delivered effectively it can be very successful, make sure you are confident and up to date with choking first aid and CPR training, and if you are not book a course with us today.
Other tips to reduce the risk of choking…
Because choking is often silent, we recommend teaching your entire family to bang on the table to make a loud noise to attract attention if they are ever choking
Name coughing from a young age, every time your infant coughs say “good coughing” or “that’s a cough, you are coughing” that way when you encourage them to cough during an airway obstruction, they will know exactly what to do.
It’s not always food that children choke on. Before your child is on the move, remember to baby proof your home. Taking special care to move all items smaller than a 20c piece up to places where little hands cannot reach. If you need help working out what needs putting away just invite us over with our toddlers and you will know in less than a minute.
What is post choking aspiration?
In all instances of choking, even if the foreign object becomes dislodged, you should consider taking your child to be assessed by a doctor, preferably in the emergency department. This is because there is a risk of aspiration.
Aspiration occurs when a foreign object enters the lungs, this could be food, liquids (including gastric content) or other items. Aspiration can occur during a choking episode and can lead to an infection of the lungs or bronchioles, this is called aspiration pneumonia or aspiration bronchiolitis.
Some signs or symptoms of aspiration are; A wheeze or other noisy breathing, coughing, hoarse voice, weak sucking for babies who are breast or bottle fed, a fever, breathing difficulty or excessive salivation or drooling.
If you think your child may have aspirated, take them to hospital immediately or call 000 for an ambulance.
And that wraps up our choking prevention blog! remember prevention is key here. If you want to feel confident managing a choking emergency, head to our course page and sign up for a course with us today.