Heimlich.docx

Wesleyan University Philippines College of Nursing and Allied Medical Sciences NCM 106: Care of the Client with Cellular Aberrations, Acute Biologic Crisis Including Emergency and Disaster Nursing Name of Student: ____________________________________________ Date: __________ Year and Block: __________

HEIMLICH MANEUVER Purpose: To remove upper airway obstruction by a foreign object PROCEDURE: CONSCIOUS INFANT (younger than one year) PREPARATION 1. Assess the infant. a. If a baby cannot breathe, cough or make sound, perform Heimlich Maneuver. Note: Do no try Heimlich Maneuver unless you are sure that the infant is choking.

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2. Grab the infant. Put the baby facedown on the forearm so the baby's head is lower than his or her chest. 3. Support the baby's head in your palm, against your thigh. (Don't cover the baby's mouth or twist his or her neck.) 4. Use the heel of one hand to give up to 5 back slaps between the baby's shoulder blades. 5. If the object does not pop out, support the baby's head and turn him or her on your thigh positioning the head lower than his body. 6. Do chest compressions. Place 2 or 3 fingers just below the nipple line on the baby's breastbone Push for approximately one inch deep. 7. Give 5 quick chest thrusts. 8. Repeat giving 5 back slaps and 5 chest thrusts until the object comes out or the baby faints. 9. If the object comes out, put in the recovery position; if the baby faints, call for help. UNCONSCIOUS INFANT (younger than one year) 1.

If infant becomes unconscious, call for help.

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Wesleyan University Philippines College of Nursing and Allied Medical Sciences 2.

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Carefully lower the infant onto a firm, flat surface and give care for an unconscious choking infant. Look for the object blocking the airway. If the object is visible, remove by finger sweeping. If not, do not attempt. Give two rescue breaths. Do head-tilt/chin lift maneuver. a. Make complete seal over infant’s mouth and nose. a. If the chest does not clearly rise with rescue breaths, the airway could be blocked. Retilt the head and give another rescue breath. Using your two fingers, give 30 chest compressions about one inch deep in between the nipple at the rate of 100 chest compressions per minute. Open the infant’s mouth. a. If you see the object, remove it with your little finger. i. Using your two fingers, give 30 chest compressions about one inch deep in between the nipple at the rate of 100 chest compressions per minute. ii. Give another two rescue breaths, if the air goes in, check for the breathing and pulse no more than 10 seconds. iii. Put the infant in to recovery position. b. If the object does not come out, give another two rescue breaths. i. Using your two fingers, give 30 chest compressions about one inch deep in between the nipple at the rate of 100 chest compressions per minute. ii. Continue the cycle of modified CPR until the object comes out or any help arrived.

CONSCIOUS ADULT AND CHILD (older than one year) 5 1. Assess the patient. a. Ask the patient if he/she is choking. b. If the patient is coughing, allow him or her to expel the foreign object by himself.

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Wesleyan University Philippines College of Nursing and Allied Medical Sciences c. If the patient cannot respond, look for the universal choking signal (hands clutched to throat). Note: Do no try Heimlich Maneuver unless you are sure that the person is choking. 2. Stand/kneel behind the patient. 3. Wrap your arms around the patient’s waist. 4. If a person is standing, place one of your legs between the patient’s legs so you can support the person if he/she faints. 5. Make a fist with one hand. 6. Place the thumb side of your fist above the navel and below the breast bone. 7. Cover your fist with your other hand. 8. Give a quick in and upward thrust into the belly. 9. Repeat thrust until the object pops out or the patient faints. 10. If the child or adult faints, call for help. UNCONSCIOUS ADULT AND CHILD (older than one year) 5 1. 2.

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If infant becomes unconscious, call for help. Carefully lower the patient onto flat surface and give care for an unconscious choking child or adult. Look for the object blocking the airway. If the object is visible, remove by finger sweeping. If not, do not attempt. Deliver two rescue breaths. Do head-tilt/chin lift maneuver. a. Pinch the nose shut and place your mouth over the person's mouth to make a complete seal. Blow into the person's mouth to make the chest rise. b. If the chest does not clearly rise with rescue breaths, the airway could be blocked. Retilt the head and give another rescue breath. Give 30 chest compressions. a. Push hard, push fast. Place your hands, one on top of the other, in the middle of the chest. Use your body weight to help you administer compressions that are at least 1 ½ to 2 inches deep and delivered at a rate of at least 100 compressions per minute. Open the patient’s mouth.

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Wesleyan University Philippines College of Nursing and Allied Medical Sciences c. If you see the object, remove it with your finger. i. Deliver two rescue breaths. If the air goes in, check for the breathing and pulse no more than 10 seconds. ii. Put the infant in to recovery position. d. If the object does not come out, give another two rescue breaths. iii. Give 30 compressions. iv. Continue the cycle of modified CPR until the object comes out or any help arrived. Student’s Signature :___________________________________________ Date: ___________ Instructor’s Name and Signature: ________________________________ Date: ___________ Comments and Suggestions: ______________________________________________________________________________ ______________________________________________________________________________

Prepared by: CHEENA P. BERBER, RN MAN LPT NCM 104 Instructor/ 4-2 A.Y 2017-2018 1st Semester

Subject for revisions. Open for comments and suggestions. References: American Heart Association – http://www.heart.org/HEARTORG/ American Red Cross - http://www.redcross.org http://www.mayoclinic.org/first-aid/first-aid-cpr/basics/art-20056600

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