Foreign body in the respiratory tract: first aid
Jun 08, 2018
One of the most critical pathologies that anyone can face is a foreign body in the airways.Emergency care in these situations should be provided instantaneously - in the first seconds.Certain maneuvers, which everyone can master, can save a life for an adult and a child if they are applied immediately.Table of contents: Causes of ingress of foreign bodies into the respiratory tract Symptoms of foreign body in the respiratory tract
Causes of ingress of foreign bodies into the respiratory tract
In many cases, this pathology develops in children of childhood.This is due to the peculiarities of the behavior of babies - during food they tend to play, talk, laugh or cry, cough.In addition, children very often take in mouth various small objects that can then accidentally inhale.The anatomical features of the oral cavity and the underdevelopment of protective reflexes in children also contribute to the increase in cases of aspiration( inhalation) of foreign bodies( IT) in young patients.
Adults most often suffer from this pathology with greedy absorption of food without chewing it or with an active conversation while eating.Another "aggravating circumstance" is alcohol intoxication, in which the activity of the nerve centers responsible for protective reflexes decreases.
Symptoms of a foreign body in the airway
The peculiarity of this pathology is that most often it occurs during eating.This is important information, suggesting that a person loses consciousness precisely because of a foreign body, and not, for example, a heart attack( although it is possible).
The clinical picture of the foreign body undergoes three stages of its development :
- the initial stage, in which there is a sudden strong paroxysmal cough, lacrimation, reddening of the face;
- development - cough becomes stronger, there is almost no breathing, although the patient does breathing movements, cyanosis appears around the lips;
- the final stage, during which the breath stops, the person loses consciousness, after a short time there is a stop of cardiac activity, followed by a clinical death.
How to recognize a foreign body in the airway by external signs
The moment of foreign body entry into the respiratory tract looks like this:
- suddenly a person stops talking, laughing, screaming or crying, clutching his throat;
- there is a strong cough, the victim ceases to answer questions;
- at attempts of the victim to inhale or rattles are audible, or nothing is audible;The victim opens his mouth wide, but can not breathe;
- the person, which at first blushes, quickly becomes pale, and then acquires a cyanotic color, especially in the area of the upper lip);
- for a few tens of seconds there is a loss of consciousness due to stopping breathing;
- in a very short time the work of the heart stops and clinical death sets in.
First aid for foreign bodies of the respiratory tract
A person who knows how to recognize this pathology will not lose a second.The situation develops rapidly and procrastination with the first aid can cost the victim life.
The algorithm for this pathology is as follows:
- Contact the victim with the question "What's wrong?" You may look stupid, but in fact this question is needed to understand if a person breathes at least somehow.Your further tactics will depend on this.
- If a person at least somehow breathes, encourage him with the words "Cough, stronger, more, give" - any words that "break through" to his mind.Often this is enough to ensure that a foreign body of a small size that has fallen into the upper respiratory tract, independently left.
- If the spontaneous exit of IT has not occurred within 30 seconds or if a person has not breathed from the very beginning, then Heimlich's maneuver should be applied.
The technique of its execution is as follows:
- Stand behind the victim.
- Grab his torso with both hands, cover the fist of the right hand with the palm of the left hand and make five strong clicks on the upper abdomen with the thumb of the right hand.Direction - up and up.Restoration of respiration is a sign of the removal of the foreign body of their respiratory tract.
Note: Heimlich's maneuver should be performed until IT leaves the airway or until the person unconscious.In the latter case, attempts to extract a foreign body should be stopped, and instead begin cardiopulmonary resuscitation .
Heimlich maneuvering features in children and pregnant women
When removing foreign bodies of the respiratory tract in children under 1 year of age, the lifeguard must sit down, put the child on the left forearm face down, holding the lower jaw of the baby folded in the "claw" with fingers.The head of the child should be below the level of the trunk.After that, you should apply five average force of blows with the base of the palm to the interscapular area of the back.The second stage - the child turns face up on the right forearm, after the forehead rescuer produces five jogging movements on the sternum to a point located on 1 finger below the interspecies line.Do not press too hard to break the ribs.
If a foreign body appears in the oropharynx, it is visible and can be removed without the danger of pushing it back - it is removed.If not, repeat the whole cycle, either before the appearance of IT, or until the cardiac arrest stops, after which it is necessary to begin cardiopulmonary resuscitation.
In children aged 1-8 years, the Heimlich maneuver is carried out by placing the child on the lifter's thigh.The rest of the actions are performed according to the general rules.
For more information on emergency care for a foreign body in the respiratory tract, you will receive a video review of the pediatrician, Dr. Komarovsky :
Typical errors in the extraction of foreign bodies of the respiratory tract
The first thingComes to mind when a foreign body enters the respiratory tract - knock on the back.Above we describe the correct algorithm for how to knock.However, most of us just bang on the back that there are forces.The danger of this method is that gravity acts on any foreign body.Incorrect tapping can cause IT to penetrate lower into the tracheobronchial tree and can cause complete blockage of the airways.The first help in this case is tracheotomy, and even if by some miracle a qualified specialist appears, the chance of rescuing the victim will become scanty.
Never turn your baby upside down in order to shock him.Spasm of the larynx reduces your attempts to extract the foreign body to zero.Instead, you can dislocate the cervical vertebrae of the baby.The fact is that when a child's consciousness is lost, the tone of the muscles of the neck falls, during the shaking his head starts to dangle in all directions, which can lead to dislocation of the cervical vertebrae and even their fracture.Saving a child from death, you risk making him disabled or even killed.
And the last, most typical mistake is panic.This feeling paralyzes the mind and body and prevents it from acting properly.Panic can be avoided if you pre-train on dolls or friends.Then in a critical situation your brain will choose the optimal algorithm of actions, and the hands will make all necessary manipulations without any admixture of emotions.And this is what a rescuer does from a simple person.
Bozbey Gennady Andreevich, ambulance doctor