CPR and Choking
                                                            Nathaniel Genther
                                                            Walden University
                                                           Instructor: Erin Eissler



                                                            CPR and Choking
Lets try to imagine a moment walking into a scenario, in which you are trained to handle as a teacher.  How might you react and what are the steps in which you should approach the situation.  The first scenario is dealing with a child choking, this since these may be closely linked we will graduate the scenario as one set, meaning that you will be going through the steps and graduating the response all the way to Cardiopulmonary Resuscitation otherwise known as (CPR).
Choking Scenario:
            You enter a room on an otherwise normal day, as you look across the cafeteria you take in the smell of tasty shrimp.  Suddenly to your immediate right you hear the sounds of Coughing, a boy is holding his throat and is hunched over his meal.
1.      Assess the situation - Use of details we know; Shrimp, Coughing, Holding throat.  This could be multiple things but the coughing is symptomatic of a restricted air way (Baby Center, 2017).  Holding throat also indicates choking, I note shrimp in case of allergy or object possibly lodged.  Assign, buddy aid from nearby responders, send bystander to retrieve needed first aid and epi-pen, assign 911 caller.
2.      Dislodge the Object – Start with a back blows, 5 firm blows, between the shoulder blades with the bottom of the palm.  If this does not dislodge, a finger swipe may remove the object, (be aware of possible biting).  If this does not work move to abdominal thrusts.  Depending on the size of the child this may be applied different methods on a child you may have to kneel or lay them down (such as in the case of a baby) in ours it is a little boy so we will kneel.  Locate belly button, make first with other hand, grasp fist and thrust upwards in the abdomen 5 times or until dislodged. Repeat back blows and abdominal thrusts alternating (to avoid bruising).
CPR Scenario:
            You have managed to dislodge the object, but the child is unresponsive and has fallen unconscious. You decide to lay the child back and double check the signs.
1.      Assess – The object is out, but the child is not breathing, what are the knowns?  The child was eating shrimp, and choking perhaps it was due to another source.
2.      Finger swipe – double check for any other objects, perhaps there is another lodged from over consumption. Be certain to tip head to the side to with thumb on jaw and view back of throat to check for swelling or objects.
3.      Check for breathing – They may be breathing out their nose but not their mouth, breathe may be only partially obstructed, listen carefully.
4.      Rescue Breathes – 2 rescue breathes, Pinch nose, use of mouth to mouth and exhale (if you have materials for assisted air such as pump, this is preferable).
5.      Move to Modified CPR – Sit to the side with childs back on solid surface, place hand on sternum and other hand on top of the first interlace fingers, perform 30 compressions.
a.       My training taught me to perform compressions to the music of “Staying Alive “it was meant to mimic the same rhythm of a heartbeat.
6.      Look for blockage – Swipe if present – use this moment to reassess (assessment is a constant process and should be always foremost). 
7.      Continue CPR until child revives, or EMS arrives, if you are performing for over 2 minutes use of buddy is necessary to maintain a constant compression rhythm.
Anaphylaxisis
            You have noticed that this child shows signs of swelling before the CPR Scenario, food is dislodged but the breathing does not exist. Assign nearby teacher or student to retrieve an epinephrine (epi- pen) auto injector.  CPR is still a viable option to maintain breathing, epi –pen can be used if known allergen is the cause.
Planning

This scenario above is assuming that you have already a plan in place, planning ahead is necessary to save lives.  If your aids you sent had no idea where to retrieve the needed supplies to save a life, the life will not be saved.  CPR is specifically set up to prolong that life, but in some cases extra supplies are needed.  Like the use of difibulator for heart attacks.  Having a trained buddy aid is necessary to help with CPR in the event you are getting tired, you run out of steam that life is over quickly (and rescue breathing is a very taxing activity.
Extra Adults
            Just as in with planning, we need to be able to use other adults to act in unison.  Planning stipulates that all are in action at once; as he does this she does that.  I mentioned a 911 caller, and other aids.  Getting a background is necessary, to save a life, calling parents immediately would be one way of ensuring safety.  Suppose I had no idea the child’s allergen history, this may be important for identifying the possible cause for unconsciousness.





















References
Baby Center (2017) First aid for Choking and CPR: An illustrated guide for children 12 months and older Retrieved from

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