A child is suffocating - what to do?

Symptoms depend on the nature of the foreign object and the place where it is stuck in the airway. When a foreign object enters the airways, a dramatic scene can happen: breathing suddenly becomes difficult, the child is suffocating, coughing, blushing. As long as the child is coughing and breathing, he/she is not in immediate danger of death. However, if the cough becomes weaker, breathing is difficult, with wheezing, the face turns blue, and the child loses consciousness, then the foreign object has completely blocked the airway.

Encourage your child to cough first!

Spontaneous cough is the best way to remove foreign objects from the upper respiratory tract. If the child is not able to cough, if he/she is not breathing, immediately remove the foreign object from the child's airway and start resuscitation.

ATTENTION! A foreign object can only be pulled out with your fingers if it is accessible and visible!

Two techniques are used to expel a foreign object: a) slaps on the back or pressure on the chest, and b) the Heimlich maneuver.

Slaps on the back and pressure on the chest

These can be performed in several ways, depending on the child's age:

  • Hold the infant on your forearm, turned "upside down" and facing the floor. Hold his/her head with the hand of the arm on which the baby is supported. With the other arm, with the heel of the hand, slap the infant with moderate force 5 times in the area between the shoulder blades.
  • Then turn the child on his/her back and support him/her with your forearm. Hold the child's head with the hand of that arm and keep the head slightly lower than the body. Similarly to heart massage, press on the sternum 5 times in a row, but harder and slower than during heart massage (one pressure should last 3 seconds). If a foreign object becomes visible after these procedures, remove it.

For a young child, perform this procedure sitting on a chair: 

Put the child on your knees, facing the floor, and keep his/her head lower than other body parts. With the heel of your hand, hit him/her hard 5 times in the area between the shoulder blades. 

For an older child, perform the procedure in a standing position:

Tell the child to cough with all his/her might. Bend him/her forward and hit between the shoulder blades 5 times with the heel of your hand. If this does not help or more severe symptoms occur, put both your arms around his/her chest, place your hands on the lower part of the sternum and press on the sternum up to 5 times.

The classic Heimlich maneuver is performed on children older than one year: 

Techniques for performing this procedure differ depending on the child's position.

  • If the child is standing or sitting, approach him/her from behind and put both your arms around the child's chest, under the armpits. Place one hand, clenched in a fist, in the middle of the abdomen, just above the navel, and put the other hand around the clenched fist. Then press upwards 5 times in a row, taking care not to press the tip of the sternum and the lower edge of the ribs. Take the position that suits you best - you can lift the child, kneel behind him/her or put the child on a chair.
  • If the child is lying (unconscious), the Heimlich procedure is performed as follows: the child is put to lie on his/her back, and the head is straightened, so that the face is turned upwards. Straddle the child's legs, put the heel of one hand in the middle of his/her abdomen (above the navel, below the tip of the sternum), place the other hand over the first and press upwards 5 times in a row. If the foreign object becomes visible after these procedures, remove it and continue with artificial respiration. If artificial respiration does not lead to the chest rising, repeat the same procedure to expel the foreign object or use another procedure.

In case of a severe obstruction, where you are not able to expel the foreign object by slaps on the back or the Heimlich procedure, start cardiopulmonary resuscitation (CPR) immediately, without delay! Apply 5 test breaths, and if the passage of air is still blocked, continue with CPR only by pressing on the chest. Call the emergency medical service a minute or two after the resuscitation begins

What not to do 

Do not try to remove an object from the child's mouth if the object cannot be seen! There is a serious risk of pushing the object even deeper into the trachea and thus aggravating the child's condition.