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You Must Be Choking

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Words by Dr Ricky Montalbano

This month our resident Bush Doctor, Dr Ricky shares tips on how to react if someone around you is choking and how to administer the Heimlich Maneuver – even if you’re a wee little thing!

DEAR BUSH DOCTOR
MY YOUNG SON HEARD US TALKING ABOUT HOW A CAMPER CAN HELP ANOTHER CAMPER THAT IS CHOKING BY USING THE HEIMLICH MANEUVER. MY SON IS 11 AND SO HE’S SMALL COMPARED TO ALL THE ADULTS IN THE FAMILY. WHAT COULD HE DO IF HE WAS ALONE WITH AN OLDER (AND MUCH BIGGER!) MEMBER OF HIS FAMILY, WHO WAS BUSY CHOKING?
SUNELLE, LIMPOPO

Hi Sunelle.
Firstly, choking occurs when there is an obstruction of the flow of air into the lungs. This obstruction can either be a complete or a partial obstruction. In the case of partial choking, some air can still enter the lungs. When complete choking occurs, the resultant lack of oxygen can be fatal. Oxygen stored in the blood and lungs can actually keep a person alive for several minutes, even after the patient has stopped breathing.

SYMPTOMS
• Difficulty in speaking.
• In the case of a partial obstruction, the patient might make gasping or wheezing sounds.
• Violent involuntary coughing, gurgling or even vomiting sounds.
• In extremely serious cases, choking victims make no sounds at all: it makes sense, as no air in and no air out equals no sound!
• The textbook definition of a choking victim states that the person desperately clutches his or her throat or mouth. I have seen numerous people choking, yet I have never seen anyone clutch their throat!
• Some people try to vomit by shoving their fingers down their throat.
• Eventually, the patient will turn blue due to the lack of oxygen.
• Finally, they become unconscious.

WHO HAS AN INCREASED RISK OF CHOKING?
It occurs more commonly in people who are attempting to eat, drink and talk all at the same time. This includes children, who commonly choke on toys or household objects. People who imbibe large amounts of alcohol also have an increased risk of choking. The elderly also choke more often because… well, because they are old? Because they have false teeth and they are very likely to choke on them? Neither, in fact – it’s simply because as we become older our swallowing reflex decreases. So, if you are old, make sure you do not get drunk and eat and talk at the same time… especially if you have false teeth! In a particular study they found that the most common object that adults choke on is the humble peanut! I wonder if the study was conducted in a pub?

TREATMENT
There are many procedures, the most common being the use of abdominal thrusts, also known as the Heimlich Maneuver (as recommended by the American Heart Association).

WHAT TO DO IF SOMEONE IS CHOKING?
• Encourage the victim to cough. Do NOT tell the person to look up or to lift their arms (Caroline!!).
• Back blows. Five hard blows with the heel of the hand on the upper back of the victim, between the shoulder blades. The back blows create pressure that may dislodge the miscreant. NOTE: Always give back slaps FIRST.

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