In the best case, the child can cough up the foreign body himself. Vigorous coughing is the most effective way to expel the foreign body. At the same time, the child’s state of consciousness must always be observed.
If ineffective cough and child is conscious:
Place child in head-down and prone position on lap or forearm.
Dosed blows to the back between the shoulder blades to get the foreign body moving.
In children up to one year of age: alternating with chest compressions (5 back blows, 5 chest compressions).
In older children: alternating with Heimlich maneuver (synonym: Heimlich maneuver; abdominal (affecting the abdomen) compressions) – life-saving immediate measure in case of impending suffocation or bolus death Procedure: The rescuer grasps the patient’s upper abdomen from behind with his arms, forming a fist with one hand and placing it below the ribs and sternum. He then grips the fist with the other hand and pulls it straight back toward his body with a jerky force. This creates an increase in pressure in the lungs, which is intended to move the foreign body out of the trachea. The maneuver may be performed up to five times.Contraindications: unconsciousness, condition after drowning, airway not completely closed (eg, by fish bone), age < 1 year.
In case of persistent coughing or obvious breathing problems, call 911 immediately!
Child is without consciousness:
Esmarch handle (by a skilled person!) – airway is kept/cleared; retrieval of foreign body may be possible (Magill forceps).
Place index finger of both hands behind both jaw angles, pull up and simultaneously try to open the mouth.
Cave: If there is no visibility into the throat, do not attempt to grasp the foreign body by reaching aimlessly.
In the absence of spontaneous breathing: cardiac pressure massage with ventilation until the emergency team arrives.
5 initial ventilations – this will, in the best case, push the foreign body into one section of the lung, allowing the rest of the lung to be re-ventilated
Resuscitation – compression/ventilation ratio:
For professional first responders 15: 2
For laymen 30: 2
An inconspicuous child with suspected ingestion of a foreign body should be well observed. In addition, the stool must be checked to see if the foreign body has been excreted. If this is not the case after a week, a pediatrician should be consulted.
