What To Do In An Emergency Situation: Choking

Would you know what to do in an Emergency? It is every parent’s worst nightmare. For some reason your baby has stopped breathing! Midwife, ER Nurse and Mother of Two Edwina has been there in the emergency room when parents arrive with sick or critically unwell babies. It was seeing the fear and distress this caused for parents and their babies that led Edwina to launch Birth Beat Baby and Child First Aid online course, so that all parents could have access to this information. 

Let’s face it, we focus so much time and energy on often getting pregnant, preparing for labour and birth, and then all of a sudden we are left in charge of this tiny human, and nobody included the manual on if they get sick. So today Edwina is going to cover one of the most common reasons a paramedic is called to the home for children under 4. Choking.

Choking
One of the biggest areas of confusion for new parents is understanding the difference between gagging and choking. This is especially common when parents start introducing solids to their baby and bub is trying to learn how to maneuver food around their mouth, chew and swallow. For many first-time parents, a gagging baby (which is completely, developmentally normal) can be quite confronting if not scary.

What’s the difference between gagging and choking?
A gagging baby will make a noise, possibly go a bit red in the face and look like they’re trying to get something up – mostly likely some food they should have chewed a bit more before attempting to swallow! The gagging sounds awful!  But it is all a natural part of their learning process as they discover how to bite off the right amount of food, chew it the correct number of times and swallow.

As a parent, watching this can be quite distressing. Your instinct will probably be to try and pat them on the back and ‘get it up’. But what I teach parents in our program is that they should sit on their hands, put a big smile on their face and say encouraging things like ‘good girl! Chew, chew chew.”

As a basic rule of thumb, if they’re making noise it means air is getting through the airway. Always supervise your baby when they’re eating and watch for further ques. But if they’re gagging, they’ll soon get that bit of food back in their mouth or spit it out, ready to try again.

Choking, on the other hand, is when the airway is obstructed. That means there is no noise. There will likely be a colour change where you’ll notice a blue tinge around the lips and nose and they may look very frightened and alarmed but they won’t be making any sounds.

What should you do if your child is choking?
This is when you need to step into action immediately.

If you’re with another adult, get them to call paramedics Or if you’re alone, phone them straight away and put your phone on loud speaker.

In the meantime, take your baby out of their highchair (bubs should always be able to sit up and support their heads properly before starting them on solids. They should also always be fed in a proper, upright position) and place them face-down over the crook of your arm so that you’re supporting their head. Make sure you’ve got gravity working with you by ensuring their head is lower than their bottom.

Proceed with 5 firm hits with the heel of your palm, aiming for the bottom to the middle of shoulder blades. We give a full demonstration of this inside the program, but it does need to be quite firm and almost aggressive. Remember, this is potentially going to save your child’s life and is only done in an emergency.

Rotate your baby over and check to see if whatever was obstructing the airway has been dislodged. If you can see it just inside their mouth, remove it. But never try and poke around or dig something out that’s well inside their mouth as you could accidentally lodge it down further.

If the obstruction hasn’t been dislodged, you need to continue with another 5 hits to the mid to lower part of the sternum using the heel of the palm of your hand. You may need to rotate baby again and do another 5 hits to the back.

This is a very effective method for choking in babies but in some cases, you may need to proceed with CPR if the child loses consciousness.

The hope is that you’ve called emergency services and by the time help arrives, your bub has had a big vomit, the blockage has been dislodged and they’re crying. But in the event that you can’t, you need to know you’ve done everything possible to give your child the chance of a full recovery.

Inside our baby & child first aid program, we cover exactly when to know to start CPR and how to perform CPR on babies, toddlers and older children.

Please be aware that this post is not intended as medical advice or information in place of first aid education. It is merely to give parents some insight into one of the most common areas of confusion around choking and gagging. And, to give you an idea of the types of skills you’ll learn in a baby & child-specific first aid course.

It’s a horrible thing to imagine, but accidents and emergencies do happen. Children choke. They can drown in a shallow bath in just moments, they slip, trip and fall. Getting the knowledge to know exactly how to respond is so crucial and will help you act calmly and effectively. It’s better to be prepared and never need to use the information than to wish you’d known what to do in a life or death situation.

Edwina is a passionate health advocate who has embraced technology and innovation to build an online childbirth education platform. Edwina has over 14 years experience as a midwife, neonatal intensive care nurse and emergency nurse. She’s delivered 100’s of babies and helped 1000’s of parents prepare for their best birth. She’s a proud mum of two and turns to mush in the presence of a baby. You can find out more about BirthBeat on their website here and keep up to date on Instagram here.