What is choking?

Choking, which consists of obstruction of the airways, also called "choking", is a very common type of domestic accident which can be dramatic, affecting both children and adults.

Children are particularly vulnerable to ingesting small objects or foods that can obstruct the airways, as are the elderly, and especially those suffering from brain diseases.

The number of deaths by suffocation of people aged over 65 has increased almost threefold over the last 30 years. Diseases of the nervous system (dementia, mental disorders, cerebrovascular diseases, etc.) are factors that significantly increase the risk of suffocation in the elderly.

In France, the average emergency response time is 11 minutes while the time without breathing leading to irreversible or even fatal consequences is 3 minutes...

Definition of airway obstruction or “false path”
Airway obstruction often results from accidental inhalation of objects (piece of puzzle or toy, plastic, tooth or dental crown, battery, etc.) or food (peanut, capsules, candy, sugared almonds, cartilage). , piece of meat too large, etc.).

This type of accident can occur quickly, and can affect everyone in the household: the immediate victim of choking, or those around them, sometimes unable to solve the problem, leading to feelings of guilt with significant psychological consequences. .

The location of the obstruction in the airways (pharynx, larynx, trachea, bronchi) can vary and, the deeper the object has descended, the more critical the situation is and requires immediate medical intervention.

Hence the importance of knowing the appropriate rescue actions.

Signs of a wrong turn
Symptoms vary depending on the severity of the obstruction and the age of the individual:

  • In children under two years of age, signs may be very subtle, and include absence of cough, noticeable paleness, and immobility.
  • In children over two years of age and adults: signs include sudden cough, difficulty breathing, inability to speak, and restlessness. If the obstruction persists, signs of asphyxia appear: cessation of coughing, worsening breathing difficulties, blue lips and nails, sweating, panic, and increased heart rate.

Intervention in case of choking, without Dechoker.
When a person is choking, rapid intervention is vital.
Without dechoker, depending on age and type of obstruction:

For a partial obstruction it is important not to aggravate the situation.

In children or adults:

  • Seat the person
  • Encourage her to cough: Coughing is a reflex movement of the body that can sometimes cause the object to come out naturally.
  • Seek medical advice urgently.

If the victim regains his senses and manages to breathe normally, he is naturally out of danger. Discomfort may be felt for a few hours at the site of the obstruction due to friction.

In babies:

When it is a baby who is choking, the process is even more complicated due to the size and fragility of the individual.

  • Sit on a chair, and place the baby on your lap, face down, to administer the back slaps. They are done in the same place as for children and adults, with a force adapted to the size of the baby. Be careful to place your hand at an angle to the baby's body, so as not to hit the head.

For total obstruction, often represented by the absence of cough, you must act extremely quickly:

In children or adults:

  • Start by giving 5 slaps on the back, with the flat of the hand, between the shoulder blades: you have to hit hard, in order to make the stuck object move. Between each slap, listen. A start of coughing will indicate that the object is no longer completely blocking the respiratory tract.
  • If this is not enough, you need to change your technique. You will do abdominal compressions, also called the Heimlich method. To do this, stand behind the person and place your arms under theirs. Find the navel and place your closed fist a few centimeters above it, with the back of your hand facing the sky. Place your second hand on the first, and pull sharply diagonally, backwards and upwards. You will do up to 5 abdominal compressions, checking carefully between each compression if the person is breathing again. If the person does not start breathing again, chain the slaps and abdominal compressions in series of 5 until the object comes out. Be careful to never practice these gestures on people who are too fragile (pregnant, weak, having suffered special operations, etc.) at the risk of causing other trauma.
  • After such maneuvers, the person must be seated and contact the emergency services, even if the object has come out! It might have done damage inside the body and the person needs to be examined by a doctor.

In babies:

He  It is not possible to do Heimlich compressions: his organs are too fragile and abdominal compressions could risk injuring him.

  • Return  the child to place him on his back and make compressions on the chest, with two fingers, in the same place as for the cardiac massage . As in adults, perform up to 5 compressions.
  • If the baby takes a breath or cries, leave him in a sitting position (seat type) in your arms. This will make it easier to breathe while waiting for help to arrive.

Attention !!

If you are alone and you are completely choking, there is an emergency. Impossible to slap you on the back, nor to give you effective abdominal compressions.

To date, there is no recognized rescue technique for recovering from serious choking on your own.  Only the Dechoker and potentially similar devices can offer you any chance of relief.

In the absence of an anti-choking device, the best thing to do would be to seek help from people close to you (neighbors, colleagues, passers-by, etc.). This way, they can help you by carrying out emergency procedures or they can call for help if you lose consciousness. The priority in this situation is to ensure that emergency services are notified.

For a total obstruction causing an unconscious state:

In children or adults:

  • Call for help
  • Give 30 compressions to the center of the chest
  • Open the victim's mouth to check for the presence of a foreign body. Take it off if you see it.
  • Give one breath: If the air passes: give a second one / If the air does not pass: lower the chin before raising it to open the airways. Try again.
  • Give 30 compressions;
  • Repeat the steps until the piece comes out, there is a change in the victim's state of consciousness, or help arrives.

In babies:

  • Call for help
  • Administer 30 compressions
  • Open the baby's mouth to check for the presence of a foreign body. Take it off if you see it
  • Give a (light) breath: If the air passes: give a second /  If air does not pass: lower the chin before raising it to open the airways. Try again.
  • Give 30 compressions;
  • Repeat the steps until the piece comes out, there is a change in the victim's state of consciousness, or help arrives.

Intervention in case of choking, with Dechoker:

Try the methods suggested above, which can be effective: back slaps, then abdominal compressions. If you are unable to perform them (obese or pregnant or fragile victim - young child or elderly person - or presenting a risk of additional trauma - back pain, bone deficiencies, etc.) or if you are insufficiently trained:

  • Make sure you have positioned the mask adapted to the size of the victim's face on the Dechoker
  • Once the Dechoker is ready, position the mask on the victim's face, ensuring that no air passes to promote the suction effect.
  • Pull firmly on the device handle, keeping the mask firmly positioned on the victim's face to dislodge the stuck object. Repeat until the airway is clear.
  • Once the object has been dislodged, ensure the victim's well-being and reassure them.

Prevention and awareness
It is vital to know the actions that save. On a daily basis, simple measures can reduce the risk of going astray:

  • Do not leave small objects within the reach of children
  • Avoid leaving your children alone with small toys
  • Explain to them the importance of not ingesting unsuitable products
  • Adapt the size and texture of food to the person's age and swallowing abilities;
  • Supervise your children during meals or play;
  • Put away plastic bags and other dangerous objects, no matter how harmless they may be (puzzles, peanuts, protective pads, etc.)
  • Put your young children to sleep on their backs and alone in their bed
  • Eat slowly and chew carefully before swallowing;
  • Maintain good oral hygiene and visit a dentist regularly.