Some situations call for quick decisions about breathing. This lesson deals with choking, fainting, the unconscious person who is breathing and the recovery position.
Choking
Choking happens when a foreign body, usually food, blocks the airway. There are two degrees.
Mild obstruction. The person can cough, speak and breathe. The best thing is to encourage them to cough and keep watch. Do not slap the back of someone who is coughing effectively.
Severe obstruction. The person cannot speak, breathe or cough, puts their hands to their throat and turns blue. The sequence the INEM promotes is:
- Lean the person forward and give up to 5 back blows between the shoulder blades, with the heel of the hand.
- If that does not work, give up to 5 abdominal thrusts (the Heimlich manoeuvre): standing behind the person, with a fist above the navel, pulling quickly inwards and upwards.
- Alternate blows and thrusts until the object comes out or the person becomes unconscious.
- If they become unconscious, call 112 and start basic life support.
Anyone who has had these manoeuvres done on them should be checked at a hospital, because the thrusts can cause injuries. For babies the manoeuvres are different: the blows are given with the baby face down and abdominal thrusts are replaced by chest compressions. This is the kind of action you learn on a practical course.
Fainting
Fainting is a brief loss of consciousness, usually because the brain briefly lacks blood: heat, fear, pain, standing for a long time, lack of food.
- Warning signs: dizziness, cold sweats, pallor, blurred vision.
- If someone feels they are about to faint: sit or lay them down, with the legs raised.
- If they have already fainted: lay them on their back, raise the legs, loosen their clothing and check whether they are breathing.
- The person usually recovers within moments. They should get up slowly.
- Call 112 if they do not recover quickly, if they hit their head, if they have chest pain or shortness of breath, if they are pregnant, or if they have a heart condition or diabetes.
Unconscious person who is breathing
If a person does not respond but is breathing normally, there is a risk that the tongue or vomit will block the airway. The solution is the recovery position, and you must call 112.
One way to do it, in simplified form:
- Kneel beside the person, who is lying on their back.
- Place the arm nearest you at a right angle, palm up.
- Bring the other arm across the chest and hold the back of the hand against the cheek on your side.
- Bend the far knee and roll it towards you, so that the person ends up on their side.
- Tilt the head slightly back to keep the airway open, and adjust the hand under the cheek.
- Keep checking the breathing continuously. If it stops being normal, lay them on their back again and start BLS.
The recovery position is used for someone who is breathing normally. It is not used for someone in cardiac arrest, nor with a suspected spinal injury, unless the airway is at risk.
Feeling unwell with difficulty breathing
In an asthma attack, the person should use their usual medication (inhaler), if they have it, and stay seated and calm. If they do not improve, call 112. The same applies to sudden shortness of breath of unknown cause.
What not to do
- Do not give water to someone who has difficulty swallowing or is drowsy.
- Do not leave alone a person who has felt unwell.
- Do not slap the back of someone who is still coughing well.