Now let's cover the highly effect and very important skill called conscious adult choking.
Now in this scenario we have someone who is eating at a table, they begin to choke, we
know they were choking because they could not cough, they could not breathe, they could
not speak. This is a full obstruction if and it need's help if it's gonna come out in most
cases. If it's easy to activate the emergency response team or call 911, great, but if not,
we can wait until the patient goes unresponsive before we actually take the time to call 911
or activate a code. But in this case we're gonna come up to the person, we're gonna look
them in the eyes, "Are you choking"? They nod "Yes". "I know how to help you. May I
help you". They give me permission to help them. They're still conscious and so we wanna
get that permission from the patient if at all possible. Now I'm gonna elevate their
elbows, I'm gonna find the belly button. The belly button is my landmark so that I can
tuck my thumb in and put the fist just above the belly button on their abdomen. I wanna
stay below the xiphoid process which is approximately right here, I wanna stay just above the belly
button because this is where i find the diaphragmatic region. This is exactly what I want so that
I can bring that diaphragm up and in while I compress the lower lobes of the lung, shoot
the air up the trachea, popping that object out, and it's effective the majority of the
time. So I'm gonna take that hand, keep my elbows out so I'm not on their ribs anymore
than I have to be, and I'm gonna start with my inward and upward thrust. And I'm gonna
do these thrust, until either the object comes out or the person goes unresponsive. In this
case the object did come out. He began breathing, coughing, clearing his own airways. I simply
re-encourage him that he's doing fine. If he feels like sitting down you can have him
sit down. And if we had not already called 911, now would be the time to call 911 or
call a code "if" they go unresponsive. If we've already called 911 keep 'em coming,
it's fine. Even though the object already came out, it's always a good idea to have
EMS stay on the way, so that if this person opts not to go in, they can be checked out
by the EMS professionals. They're gonna check airway, they're gonna check some lung sounds
to make sure there's no partial obstruction, and they're probably do a quick assessment
to make sure there is no internal bleeding from the abdominal thrust. So if the individual
does not opt to have that done to him, or the EMS providers do not come, I always like
to encourage them to go to their own practitioner and just be looked over and made sure that
everything is okay. Keep in mind, that if this person were not to have this successful
removal of the obstruction, they would probably go unresponsive in a short amount of time.
And it's then that we would assist them to the ground carefully and begin the skill of
unconscious adult choking. Now we're gonna talk about special considerations as it relates
to a pregnant woman. You know when we're doing this lifesaving skill of trying to remove
the obstruction from the airway, and the person is pregnant, we need to understand that we're
dealing with two patients, save mom, save baby. So it's important that we're aggressive
in our treatment, but there's a special way to do it so that we don't injure the baby
in the process. Let's take a look at how we do that right now. When we have the, the person
in front of us, we know the baby is here in the normal location where we would do abdominal
thrust. So we're gonna avoid the area altogether by forming the fist and going under the breast
with that fist on the sternum. We're then gonna take that opposite hand, go under the
breast and onto that fist that's on the sternum. We're now gonna do inward thrusts, inward
deep thrusts. And we're gonna continue to do those compressions until the object comes
out and the person begins to breathe normally again. If they doesn't come out, they're gonna
go unconscious. When they go unconscious, we're gonna activate 911, and then we're gonna
start doing our unconscious choking victim compressions as we learned in the other segment.