Choking (for unconscious infant under 1 year)

Alternative names:

Heimlich maneuver - unconscious infant

First aid:

1. Place the baby with his or her back on a hard surface, keeping the back in a straight line, firmly supporting the head and neck. Expose the child's chest.

2. Open the infant's mouth with your thumb and index finger, placing your thumb over the tongue. If the object is visible and loose, remove it.

3. Lift the infant's chin while tilting the head back to move the tongue away from the windpipe. If a spinal injury is suspected, pull the jaw forward without moving the head or neck. Don't let the mouth close.

4. Place your ear close to the infant's mouth and watch for chest movement. For 5 seconds, look, listen, and feel for breathing.

5. If the infant is not breathing, begin rescue breathing. Maintain the head position and cover the mouth and nose tightly with your mouth. Give 2 slow, gentle breaths, each lasting 1 second with a pause in between.

6. If the chest does not rise, begin back blows. Lay the infant face down along your forearm with the child's chest in your hand and the jaw between your thumb and index finger. Use your thigh or lap for support. Keep the infant's head lower than his or her body.

7. Give 5 quick, forceful blows between the child's shoulder blades with the heel of your other hand.

8. Turn the infant over to be face up on your other arm. Use your thigh or lap for support. Keep his or her head lower than the body.

9. Place 2 fingers on the middle of the breastbone just below the nipples.

10. Give 5 quick thrusts down, depressing the breast 1/2 to 1 inch each time. Each thrust is a separate attempt to clear the airway by forcing air out through the child's windpipe.

11. Open the child's mouth with your thumb and index finger, placing your thumb over the tongue. If the object is visible and loose, remove it. Observe the child's breathing. If the infant stops breathing, begin CPR (for infant under 1 year).

12. If the object is not dislodged, give 5 back blows and 5 chest thrusts, and then check for the object. Repeat this sequence until the object is dislodged or help arrives.

13. If the baby starts having convulsions or seizures, refer to first aid for that condition (see convulsion, first aid).

Do not:

• DO NOT try to grasp the object lodged in the infant's throat; you may push it farther down.
• DO NOT begin CPR (if the breathing has stopped) until the airway is cleared.

Call immediately for emergency medical assistance if:

• a baby experiences choking. Even if you successfully dislodge the obstruction and the infant seems fine, call the doctor for further instructions.

If you are not alone, have one person call the local emergency number while another person begins first aid. If you are alone, call for help, and then begin first aid.