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First Aid Do Not Bend Over A Chair For Choking Except For Self-help Abdominal Thrust. Suggest?

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Posted on Sat, 28 Sep 2013
Question: I am a nurse and I remember 20 years ago I watch a first aid video of choking, the rescuer positioned the victim behind a chair and bend him over, then perform back slapping and abdominal thrust. However, from Red Cross and St XXXXXXX they do not mention "bend over a chair" except for self-help abdominal thrust. Is it proper to do what I seen 20 years ago?
doctor
Answered by Dr. Lohit K (48 minutes later)
Brief Answer:
abdominal thirst without bending over chair

Detailed Answer:
Hi thanks for using XXXXXXX

In choking, giving abdominal thrust is the prime important to remove any foreign body from the airway.
The thrust should be given in UPPER abdomen.
If the patient bends over the chair the thrust will be given to the lower abdomen without causing the respiratory muscles to contract (Instead only displacement and compression of intestines will occur).
The patient should be asked to vomit or spit whatever comes to his mouth / oropharynx and hence during that time he needs to bend over.

So the right procedure is to give abdominal thirst without bending over chair.

In the first aid and cpr courses, they mostly focus on giving CPR to unconscious patients.

Hope this explanation clarified your doubt. Feel free top ask if any related query.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Lohit K (3 hours later)
Thankyou for your answer. However, my question is why not back slapping together with bending back over a chair
.
I can surely remember the video of placing victim behind chair for supporting, when victim bend his back, the rescurer performed back slapping.

For abdominal thrust with chair, it is still recommended in self-helf condition, that is when choking happens in the first-aider.
doctor
Answered by Dr. Lohit K (6 hours later)
Brief Answer:
Yes. this should be done

Detailed Answer:
Hi XXXXX,

I apologize, my last answer was not clear. Let me try today to answer it better.

Yes, this should be done. Bending over chair make the airway, pharynx and oral cavity in straight line which will help to remove/spit all the content without being struck in pharynx and re-aspiration. If this does not help then the next step is to perform abdominal thrust.

Hope this clarified your doubts. In case of any doubt, I will be available for follow-ups.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Lohit K (1 hour later)
thankyou very much for your expert advice. should i teach staff members to bend over chair? i was challenged as it was not mentioned by st XXXXXXX or red cross.
doctor
Answered by Dr. Lohit K (6 hours later)
Brief Answer:
Yes. Teach along with explanation

Detailed Answer:
Hi,

Yes you can teach your staff members by giving right explanation on when giving back slapping the neck in extended position (bending backwards) will help the patient better to remove the foreign body. But during vomiting or spitting patient should not be in this position.

If you explain the basics for the procedure then they can understand the necessity of each procedure.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well.
Wish you good health. Take care.

Regards
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Lohit K (8 minutes later)
Dear Dr Lohit,

Thankyou again for your anwer. Last question:

Do you mean my bending forward against the back of chair?
Or as you mentioned "bending backward"?

doctor
Answered by Dr. Lohit K (33 minutes later)
Brief Answer:
Forward bending.

Detailed Answer:
Hi

This what confused me in answering. Hence I explained complete basic mechanism of each procedure.
You have told bending and not specified forward or backward. (positioned the victim behind a chair and bend him over).

I thought forward bending of 60-80 degree forward bending. That why I explained to give abdominal thrust in upper abdomen.
While giving abdominal thrust (or thump) the patient should be slight forward bending position. This prevent aspiration and also help to remove foreign body in respiratory tract.

While removing the foreign body the neck in extended position (bending backwards) will help better. But this will be harmful during spitting or vomiting.
Hence during procedure slight forward bending is better to avoid aspiration. (After discussion I hope you referred slight forward bending)

Hope this explained the the reason behind bending.

Regards
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Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
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Dr. Lohit K

General & Family Physician

Practicing since :2007

Answered : 1648 Questions

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First Aid Do Not Bend Over A Chair For Choking Except For Self-help Abdominal Thrust. Suggest?

Brief Answer:
abdominal thirst without bending over chair

Detailed Answer:
Hi thanks for using XXXXXXX

In choking, giving abdominal thrust is the prime important to remove any foreign body from the airway.
The thrust should be given in UPPER abdomen.
If the patient bends over the chair the thrust will be given to the lower abdomen without causing the respiratory muscles to contract (Instead only displacement and compression of intestines will occur).
The patient should be asked to vomit or spit whatever comes to his mouth / oropharynx and hence during that time he needs to bend over.

So the right procedure is to give abdominal thirst without bending over chair.

In the first aid and cpr courses, they mostly focus on giving CPR to unconscious patients.

Hope this explanation clarified your doubt. Feel free top ask if any related query.

Regards