First aid for foreign bodies in the respiratory tract

In the respiratory tract (trachea, larynx, bronchi, nasal cavity, pharynx), most often by accident, sometimes food and small objects, which are generally called foreign bodies, enter. As a rule, foreign objects get stuck in the larynx, as it is narrow enough and does not let them through. When any object enters the respiratory tract, a person begins to cough violently. If you cannot get rid of a piece of food or other object with the help of coughing, you should contact a specialist who will correctly and quickly provide first aid.

Types of foreign bodies entering the respiratory tract

Depending on the shape and parameters, all alien objects are divided into 3 main groups. The first group includes bodies with a spherical shape: balls, tablets, capsules, soft pieces of food. These objects are characterized by non-sharp edges and can penetrate the trachea, they are removed, if possible, using the “Pinocchio effect” (it is necessary to turn upside down and hit with an open palm between the shoulder blades).

The second group includes bodies with a flat and wide surface, which are somewhat similar to coins. These items include buttons, coins, plates, body jewelry, rings, artificial nails, and others. Foreign bodies of the second group easily penetrate the glottis, but it is almost impossible to remove them in a natural way. To slightly reduce the pain of a person when a coin enters the respiratory tract, a strong tapping of the palm between the shoulder blades can. This is done so that the foreign body changes its position and the person can breathe.

The third group of foreign bodies includes objects whose shape resembles a rocker. The most dangerous objects that can disrupt a person’s breathing and get into the larynx are pieces of meat with a strong film. Pork or lamb meat becomes a rubber stopper that prevents a person from inhaling and exhaling.

The only chance to extract a piece of meat from the respiratory tract is a strong blow made just below the diaphragm or an instant cricothyrotomy (conicotomy). The dissection of the larynx can only be carried out by a medical professional who is trained in the technique of the procedure and can actually save a life.

Symptoms when a foreign body enters the respiratory tract

The first symptom that appears when there is a foreign object in the respiratory tract is a strong cough with reddening of the face, then vomiting, tears in the eyes and suffocation. If symptoms occur, it is recommended to exhale sharply so that the object blocking the larynx comes out under air pressure.

If a person cannot get rid of a foreign body, then along with a cough, stridor breathing appears with characteristic wheezing when inhaling. With each new breath, the object moves further, irritation of the mucous membrane of the trachea or larynx occurs. Due to the irritating factor, the airways begin to swell, mucus is abundantly secreted and accumulates. The most dangerous is the spasm of the glottis and swelling of the vocal folds.

When strangulated, the red color of the skin of the neck and face begins to change to blue, the cough becomes more frequent, apathy and adynamia develop, followed by loss of consciousness. After losing consciousness, the victim needs to monitor the pulse and send him to the hospital for medical attention. If this is not done, a coma may occur.

The onset of coma (blue asphyxia) is evidenced by:

• lack of consciousness;
• blue skin of the neck, face, lips;
• an increase in blood vessels in the neck;
• vulture and retraction of the supraclavicular and subclavian cavities during inspiration;
• weak pulse on the carotid artery.

After blue suffocation, after 5-10 minutes pale asphyxia begins. Pale suffocation is accompanied by pallor of the skin, the reaction of the pupils to light disappears, and the pulse is not felt.

If foreign objects enter the respiratory tract, a person has a few minutes before the onset of an attack and the appearance of clinical symptoms, so people around him should provide the correct first aid and take appropriate measures. The following two mistakes should not be made when saving a person: additionally examine the oral cavity (significant loss of time), try to remove food with a finger or other objects (part of the food or a foreign body can come off and enter the trachea, resulting in suffocation).

“Pinocchio effect” when a foreign body enters

When removing spherical bodies, you should use the “Pinocchio effect”. If the baby chokes on, for example, peas, you need to turn it over so that the head is down, then hit the palm between the shoulder blades 3-4 times. In case the food did not fall on the floor, you need to proceed to other methods. The basic technique is the “Pinocchio effect”: we turn over the choking one on the stomach, then we throw it over our thigh or the back of the chair, and only then we hit the palm of our hand several times between two shoulder blades. This method is used to extract foreign bodies from children, adolescents and adult men and women.

You can save the injured baby using this technique: we put the baby on our own forearm, insert 2 fingers into the oral cavity (if there is a piece of paper from a candy or a bag in the mouth, it should be carefully removed), then lightly hit the baby on the back until a foreign object falls out ( strong blows can injure the spinal cord and lead to disability, so their strength must be monitored). It is forbidden to shake or hold the legs upside down, as children have a very weak spine.

If after 15-30 seconds the food does not fall out of the throat, you need to change tactics. If the foreign object looks like a coin or plate, this technique will not be effective. Doctors recommend that if the method is ineffective, use the “American police method” (see below).

Emergency care in case of inhalation of coin-shaped bodies

When hit by objects that look like a coin, it is advisable to use a technique called the “piggy bank effect”. If a person swallowed a coin, you need to force the alien object to change its location. With strong blows in the chest area, it is likely that the foreign object will turn the other way and free the air passage or move to the bronchi (when the coin or button is in one bronchus, the victim will be able to breathe and have time to get to the ambulance).

The most common way to shake the chest is to tap on the back with the palm of your hand. The “method of American policemen” is also considered an effective procedure. Technique: you should stand behind the victim and take him by the shoulders, then move him away from you to outstretched arms and only then sharply hit him with his back against his own chest. This manipulation can be carried out 3-4 times. The technique is effective if the rescuer has a flat male chest.

Features of the “Heimlich method”

The “Heimlich method” is effective in removing foreign particles from the upper respiratory tract. The technique is considered one of the most risky and should be carried out exclusively by medical professionals. During a sharp blow just below the diaphragm, from 250 to 300 ml of air is pushed out of the lungs, and a foreign body flies out with the air. The risk is that with a sharp blow, reflex cardiac arrest, injury to internal organs, and bleeding can occur.

The “Heimlich method” is forbidden for babies who are not yet 3 years old. Even if the food came out with air, the victim should be taken to the hospital in an ambulance, because after such a radical method of removing a foreign body, internal organs and systems can be damaged. It is forbidden to learn this technique from each other, for this there are specialized courses and conferences.

Features of the implementation of the “Heimlich method”: you need to stand behind a choking person and wrap your arms around him, folded into a castle. In this case, the lock should be between the lower ribs and the navel. Next, the rescuer must remove the victim from himself and with all his strength hit him with his back against his chest, and press the epigastric region with folded brushes.

Cricothyrotomy

Only medical professionals are authorized to perform a cricothyrotomy, as this is a serious procedure that needs to be trained and mastered. During the manipulation, an incision is made between the cricoid and thyroid cartilages (the hole will be above the trachea and the victim will be able to breathe freely).

Surrounding people can help to carry out emergency manipulation, for this it is necessary: ​​to fix the head of the choking person (it is advisable to hold it between both knees so that the medical worker makes an accurate cut), press the hands of the victim to the floor or ground, ask people for an object in the form of a tube (it will help let air in and out of the lungs).

Rules to help avoid getting a foreign body into the respiratory tract

To prevent food and other objects from getting into the trachea and larynx, you need to follow a few simple rules. First, you can’t eat on the street, because something can frighten a person and a piece of food will get into the respiratory tract. Second – you can not talk while eating, because not only soft food, but also bones from meat or fish can end up in the throat. Thirdly, you should not keep metal objects and other foreign bodies between your teeth, which can inadvertently get into the trachea or larynx. Fourth – if a child holds a small toy near his face or licks it, you need to immediately pick it up, since the actions of the baby are often unpredictable (it is advisable to give the child a soft large toy so that he does not get upset and start crying).

Serious mistakes when removing a foreign object

With incorrect (too strong and intense) blows to the back, a foreign particle can move forward and end up in the tracheobronchial tree, thereby blocking the airways. If a foreign object has entered the tracheobronchial tree, a tracheotomy should be performed immediately.

It is forbidden to turn the child upside down and shake, because the baby’s body is still too weak and may not withstand such a load (there is a risk of dislocation and even fracture of the cervical vertebrae). The most serious mistake in a rescue operation is panic. The surrounding people and medical workers are no less afraid than the victim himself, so you need to get together and act according to the technique of extracting a foreign particle from the respiratory tract.

There are many techniques and methods that will help remove a foreign object from the larynx and other internal organs, but there are also ways of first self-help. Doctors recommend that when a foreign particle enters the respiratory tract, exhale sharply, throwing straight arms forward. Along with these movements, you need to quickly lean forward. If this event does not help and the actions of the surrounding people are not effective, you need to take the victim to the hospital for surgical intervention.