Airway obstruction OVERCOME BY FOREIGN OBJECTS
Method
1. Abdominal Thrust
2. Chest Thrust
3. Back Blow
Indication
To remove obstruction in the airway caused by foreign objects & marked by some or all of the following signs and symptoms are:
1. Suddenly unable to speak.
2. General signs of choking feeling neck seized
3. Noise during inspiration.
4. The use of accessory muscles for breathing and increase breathing difficulties.
5. It is hard to cough or coughing ineffective or unable for cough.
6. Spontaneous respiration did not occur or cyanosis
7. Infants and children dg sudden respiratory distress with cough dg, stidor or wizing.
Contraindications and Attention
1. Conscious clients, voluntary cough produces large air flow and can reply eliminate obstruction.
2. Chest thrust should not be used on the client yg chest injury, such as flail chest, cardiac contusion, or sternal fractures (Simon & Brenner, 1994).
3. In reply the client pregnant or extremity obesity, chest thrusts is recommended.
4. The nail on the hand position is crucial to avoid injury to the organs that have performed below for chest thrust.
Tools
1. Oral suction, if available.
2. Or Kelly Magill forceps and Laryngoscope (issued for a foreign object can be seen in the reply airway above).
Client Preparation
1. Client-sitting position, standing or supine.
2. Suction any blood / mucus seen freom mouth client wrote.
3. Remove all damaged teeth yg / date.
4. Prepare for airway management conducted a definitive reply, for example cricothyrotomi.
Abdominal Thrust Stages procedure
1. If a patient under the circumstances to stand / sit:
a. You stand behind the client
b. Wrap your right arm with his right hand clenched, and then hold the right arm left arm tsb dg. Position your arms clients of the abdominal pd below and above the processus xipoideus center / umbilicus.
c. Push quickly (thrust quickly), with the encouragement of the abdomen to the inside-top.
d. If necessary, repeat abdominal thrust several times for removing airway obstruction.
e. Examine the airway is common for ensuring the success of this action.
2. If the patient is supine het / unconscious:
a. You take a kneeling position / thigh straddling clients.
b. Place your left arm over your right arm against his abdomen wrote exactly under the above process and xipoideus center / umbilicus.
c. Push quickly (thrust quickly), with the encouragement of the abdomen to the inside-top.
d. If necessary, repeat abdominal thrust several times for removing airway obstruction.
e. Examine the airway is common for ensuring the success of this action.
3. If possible, look directly up and Paring client and if it looks laringoskopi priority extracting foreign objects such use or Megil Kelly forceps.
Chest Thrust Stages procedure
1. If the client sitting / standing:
a. You stand behind the client
b. Wrap your right arm with his right hand clenched in the area above midsternal process xipoideus client (the same as the position of the external cardiac compression).
c. Do push (thrust) straight down to the spinal. If necessary repeat the chest thrust several times for removing airway obstruction.
d. Examine the airway is common for ensuring the success of this action.
2. If the client supine position:
a. You take a kneeling position / thigh straddling clients.
b. Place your left arm over your right arm and position the bottom of your right arm in the area above midsternal process xipoideus client (the same as the position of the external cardiac compression).
c. Do push (thrust) straight down to the spinal. If necessary repeat the chest thrust several times for removing airway obstruction.
d. Examine the airway is common for ensuring the success of this action.
3. If possible, look directly up and Paring client and if it looks laringoskopi priority extracting foreign objects such use or Megil Kelly forceps.
Stages procedure Blow Back & Chest Thrust (for Infants <>
1. Infants positioned prone on your forearm, where the baby’s head lower than the body.
2. Prop baby’s head by holding the baby’s jaw.
3. Do it 5 times with a strong blow back between the shoulder blades using the heel of your hand.
4. Turn your baby into the supine position, prop baby’s head and neck and position it on the thigh.
5. Determine the location of the finger below nipple level as a baby. Place your middle finger on the sternum accompanied by the ring finger.
6. Perform chest with a quick thrust.
7. Repeat steps 1-6 until the foreign object out or loss of consciousness.
8. If the baby loses consciousness, open the airway and remove foreign objects if he looks. Avoid doing a finger sweep of “blind” in infants and children, because the foreign body can be pushed further into the airway.
Stages procedure Blow Back & Chest Thrust (for children 1-8 years)
1. Reply to the client standing / sitting:
a. Your position behind the client.
b. Put your arm below the axilla, around the body of the victim
c. Place your hands against the client’s abdomen, slightly above the navel and below xipoideus process.
d. Perform push upward (upward thrusts) until the foreign object out or the patient loses consciousness.
2. For clients in the supine position:
a. Your position kneeling beside the client or the client straddling thighs.
b. Place your arms above your belly button & under xipoideus process.
c. Apply thrust upward quickly, with the direction toward the middle and not directed to the side of the abdomen.
d. If a foreign object visible, remove it by using a finger sweep.
Attention!
Back blow not recommended in patients over the age of the baby.?
? wash fingers “blind” should be avoided in infants and children, because the possibility could encourage more foreign body backward into the airway.
Complications
1. Abdominal pain, ekimosis
2. Nausea, vomiting
3. Rib fracture
4. Injury / trauma to the organs below the abdomen / chest.
Health Education for Clients
1. Eat slowly
2. Cut food into small pieces
3. Chew until smooth mkanan
4. Do not talk and laugh while munching
5. Make sure your teeth / dentures you good
6. Sitting at dinner
7. Keep the food / small toys / hardware such as nuts, so far from the reach of children under 3 years
8. Forbid children to walk or run while eating for reducing the possibility of aspiration
Bibliography
Proehl, J.A. (1999). Emergency nursing procedures. (2nd ed.). Philadelphia: W.B. Saunder Company.
Further Reading:
American Heart Association. (1994). Basic life support for healthcare providers. Dallas: Author.
Simon, R., & Brenner, B. (1994). Emergency procedures and techniques. (3rd ed.). Baltimore: William & Wilkins.
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