Treatment includes a number of procedures aiming at removing foreign bodies from the<unk> s. Most modern protocols, including those of the American Heart Association, American Red Cross and the European Resuscitation Council, recommend several stages, designed to apply increasingly more pressure.<unk>  treatment includes a number of procedures aiming at removing foreign bodies from the<unk> s. Most protocols recommend encouraging the victim to cough, followed by hard back slaps and if none of these things work; abdominal thrusts (Heimlich maneuver) or chest thrusts. Some guidelines recommend alternating between abdominal thrusts and back slaps. Encouraging the victim to cough This stage was introduced in many protocols as it was found that many people were too quick to undertake potentially dangerous interventions, such as abdominal thrusts, for items which could have been dislodged without intervention. Also, if the choking is caused by an irritating substance rather than an obstructing one, and if conscious, the patient should be allowed to drink water on their own to try to clear the throat. Since the<unk>  is already closed, there is very little danger of water entering the lungs. Coughing is normal after most of the irritant has cleared, and at this point the patient will probably refuse any additional water for a short time. Back blows Most protocols recommend encouraging the victim to cough, followed by hard back slaps with the heel of the hand on the upper back of the victim. The number to be used varies by training organization, but is usually between five and twenty. For example, the European Resuscitation Council and the Mayo Clinic recommends five blows between the shoulder blades. The back slap is designed to use percussion to create pressure behind the blockage, assisting the patient in dislodging the article. In some cases the physical vibration of the action may also be enough to cause movement of the article sufficient to allow clearance of the<unk> . Abdominal thrusts US medic teaches the abdominal thrusts to Afghans Performing abdominal thrusts involves a rescuer standing behind a patient and using his or her hands to exert pressure on the bottom of the diaphragm. This compresses the lungs and exerts pressure on any object lodged in the trachea, hopefully expelling it. The European Resuscitation Council and the Mayo Clinic recommend alternating between 5 back slaps and 5 abdominal thrusts in severe<unk>  obstructions. In some areas, such as Australia, authorities believe that there is not enough scientific evidence to support the use of abdominal thrusts and their use is not recommended in first aid. Instead, chest thrusts are recommended. A person may also perform abdominal thrusts on himself by using a fixed object such as a railing or the back of a chair to apply pressure where a rescuer's hands would normally do so. As with other forms of the procedure, it is possible that internal injuries may result. Chest thrusts If the patient can not receive pressure on the abdomen, the abdominal thrusts are replaced by chest thrusts. This is the case of pregnant women, too obese people, and others. Chest thrusts are applied in the same manner than abdominal thrusts, but pressing inwards on the lower half of the sternum (the chest bone). As a reference, the zone of pressure of the chest thrusts in women would be normally upper than the level of the breasts. The pressure is not focused against the endpoint of the chest bone (which is named xiphoid process), to avoid breaking it. Finger sweep The American Medical Association advocates sweeping the fingers across the back of the throat to attempt to dislodge<unk>  obstructions, once the choking victim becomes unconscious. However, many modern protocols recommend against the use of the finger sweep since, if the patient is conscious, they will be able to remove the foreign object themselves, or if they are unconscious, the rescuer should simply place them in the recovery position as this allows (to a certain extent) the drainage of fluids out of the mouth instead of down the trachea due to gravity. There is also a risk of causing further damage (for instance inducing vomiting) by using a finger sweep technique.
Basic airway management
Advanced airway management
Surgical airway management
Blind insertion airway device
Laryngeal mask airway
Artificial ventilation
Tracheal intubation
Respiratory gas humidification