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Foreign Body Obstruction

Clinical Indications: Last update 02/2009

    Sudden onset of respiratory distress often with coughing, wheezing, gagging, or stridor due to
    a foreign-body obstruction of the upper airway.

Procedure:

    1. Assess the degree of foreign body obstruction Do not interfere with a mild obstruction allowing the patient to clear their airway by
    coughing.
    In severe foreign-body obstructions, the patient may not be able to make a sound. The victim my clutch his/her neck in the universal choking sign.

    2. For an infant, deliver 5 back blows (slaps) followed by 5 chest thrusts repeatedly until the object is expelled or the victim becomes unresponsive.

    3. For a child, perform a subdiaphragmatic abdominal thrust (Heimlich Maneuver) until the object is expelled or the victim becomes unresponsive.

    4. For adults, a combination of maneuvers may be required. First, subdiaphragmatic abdominal thrusts (Heimlich Maneuver) should be used in rapid
    sequence until the obstruction is relieved. If abdominal thrusts are ineffective, chest thrusts should be used. Chest thrusts should be
    used primarily in morbidly obese patients and in the patients who are in the late stages of pregnancy

    5. If the victim becomes unresponsive, begin CPR immediately but look in the mouth before administering any ventilations. If a foreign-body is visible, remove it.

    6. Do not perform blind finger sweeps in the mouth and posterior pharynx. This may push the object farther into the airway.

    7. In unresponsive patients, EMT-Intermediate and EMT-Paramedic level professionals should visualize the posterior pharynx with a laryngoscope to potentially identify and remove the foreign-body using Magil forceps.

    8. Document the methods used and result of these procedures in the patient care report (PCR).

Certification Requirements:

    AHA Healthcare provider card

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