What to do if a foreign body gets into the respiratory tract, esophagus, ear or nose? What happens to a person hit by a bullet? What happens when hit?
Treatment and first aid for extravasation - getting under the skin. The extent of intervention depends on the stage of extravasation, the solution administered and specific antidotes. A treatment regimen for stage 3-4 injuries has not been developed. In the absence of randomized controlled trials, some organizations have published treatment protocols based on their own experience, case series, and anecdotal evidence.
1. In all cases of extravasation - penetration of drugs under the skin do the following:
A. Stop the intravenous infusion immediately.
b. Remove constrictive bandages that can act as a tourniquet (for example, when fixing a limb).
V. Elevate the limb to reduce swelling.
d. Warming and cooling packs are used locally, which is controversial. Under the influence of heat, local vasodilation occurs, promoting reabsorption of infiltrated solutions. However, according to the literature, wet heating packs can cause maceration of the skin.
2. Extravasation of the 1st and 2nd stages:
A. The intravenous catheter is removed.
b. An antidote is chosen.
3. Stage 3 and 4 extravasation:
A. Leave the intravenous catheter in place and use a 1 ml syringe to aspirate as much of the injected fluid as possible.
b. The catheter is removed unless administration of an antidote is necessary.
V. The issue of using hyaluronidase or an antidote is decided.
d. Multiple puncture method. After extravasation with acidic or hyperosmolar solutions, intense edema develops with blanching of the skin over the site of infiltration. Using a stylet after observing aseptic measures allows the infiltrated solution to flow freely, thereby reducing swelling and the likelihood of developing necrosis. A bandage soaked in saline is then applied to improve drainage.
d. Rinse with saline solution. Some authors recommend using the method of washing subcutaneous tissue with saline solution. After treatment and infiltration of the area with 1% lidocaine, 500-1000 units of hyaluronidase are injected subcutaneously. Four small incisions are then made with a scalpel along the periphery of the infiltration site. Carry out washing. A saline solution is injected through a catheter inserted subcutaneously into one of the incisions, and the liquid is poured out through the other incision. The resulting swelling is squeezed out towards the incision with massaging movements to facilitate the removal of substances spilled from the vessel.
e. Hyaluronidase. Dispersing agents are effective in the extravasation of calcium preparations, parenteral nutrition solutions, antibiotics, sodium bicarbonate, etc. Some practice guidelines do not recommend hyaluronidase for the treatment of lesions resulting from vasopressor extravasation. However, there are also publications about the successful treatment of such extravasation using hyaluronidase in combination with saline rinsing:
(1) Mechanism of action. The destruction of hyaluronic acid, interstitial substance or intercellular connections increases the dispersion and reabsorption of fluid beyond the vascular bed, and accordingly reduces mechanical tissue damage.
(2) Administration is most effective within an hour; up to 12 hours can be administered.
(3) Inject 1 mL (150 U/mL; 5 separate injections of 0.2 mL) around the site of extravasation using 25- or 26-gauge needles.
(4) Side effects. Cases of complications in newborns have not been described in the literature; there are reports of rare cases of hypersensitivity reactions in adults.
4. Specific drug antidotes:
A. Phentolamine:
(1) Used to treat damage resulting from extravasation of vasopressors, such as dopamine and epinephrine, which cause tissue damage through intense vasoconstriction and ischemia.
(2) The effect develops almost immediately. Most effective within an hour, but can be administered up to 12 hours. The biological half-life of phentolamine when administered subcutaneously is less than 20 minutes.
(3) Mechanism of action: competitive blockade of α-adrenergic receptors, leading to relaxation of smooth muscle cells and hyperemia.
(4) Doses have not been established for newborns. They depend on the size of the damage and the body weight of the newborn.
(5) Recommended doses range from 0.01 mg/kg per administration to 5 ml of a 1 mg/ml solution.
(6) A solution at a concentration of 0.5-1.0 mg/ml is injected subcutaneously into the infiltrated area after removal of the intravenous catheter.
(7) Precautions. Hypotension, tachycardia, and arrhythmias may occur; should be administered with extreme caution in premature infants; re-introduce in small doses.
b. Nitroglycerine locally:
(1) Effective in treating damage caused by dopamine extravasation.
(2) Mechanism of action: relaxation of vascular smooth muscles.
(3) Application: 2% nitroglycerin ointment at a rate of 4 mm/kg per affected area, possibly reapplying every 8 hours if tissue perfusion does not improve.
(4) Transdermal patches are also used.
(5) Precautions. Absorption through the skin may lead to hypotension.
V. Terbutaline:
(1) Effective in the treatment of peripheral ischemia resulting from extravasation of vasopressors in adults and older children; There are no publications on its use in neonatological practice.
(2) Mechanism of action: peripheral vasodilation as a result of activation of beta2-adrenergic receptors.
(3) Administered subcutaneously at a concentration of 0.5-1.0 mg/ml; doses in adults vary from 0.5 to 1 mg.
5. Treatment of a wound after extravasation - drug penetration under the skin:
Goal of wound treatment in newborns with partial or complete loss of skin is to achieve healing by primary or secondary intention without scarring, contractures and surgical intervention. Different treatment regimens are used in different medical institutions.
A. Wash the damaged area with sterile saline solution.
b. Sulfadiazine ointment is applied to the affected area and the dressings are changed every 8 hours, carefully cleaning the wound surface, and the ointment is reapplied. Sulfonamides increase the risk of kernicterus and are therefore contraindicated in newborns in the first 30 days of life.
V. Amorphous water-based gels containing carboxymethylcellulose polymer, propylene glycol and water keep the wound moist and facilitate healing. They are produced in the form of gels and films, which can be applied directly to the wound surface and left in place during repeated dressings. The gel is easily removed with saline and is changed every 3 days. More frequent dressing changes are necessary when there is excessive exudation.
d. Wet-dry saline dressings and povidone iodine dressings are also effective. Copious application of povidone-iodine to an open wound is not recommended in very low birth weight infants because iodine absorption may suppress thyroid function.
d. The effectiveness of antibacterial ointments has not been proven.
e. Wound healing is assessed every day. Healing takes from 7 days to 3 months.
and. If the wound is on the flexor surface, perform passive exercises within physiological limits with each dressing change in order to prevent contractures.
6. Consultation with a plastic surgeon:
A. It is carried out for damage to the entire thickness of the skin and significant individual damage caused by extravasation.
b. Enzymatic or surgical debridement or skin grafting may be required.
A foreign body in the respiratory tract may occur during hasty consumption of food or during play in children. This is accompanied by signs of respiratory failure, and if the victim is not helped quickly, suffocation is possible. Such a person cannot inhale air, so he grabs it with his mouth like a fish. The ability to speak is also impaired. Many people do not know how to provide help, so intensive tapping on the back is used. But you need to understand that such actions can only worsen the situation.
How can a foreign object enter the respiratory tract?
A foreign body may appear in the upper respiratory tract for two reasons:
- A person actively talks and laughs while eating. It is in this case that most often pieces of poorly chewed food enter the respiratory tract and block it. Eating on the go, when a person is in a hurry, hastily trying to chew pieces, can also lead to blockage of the bronchi. This is why doctors recommend eating in silence, without being distracted by conversations or watching TV.
- A small child may have some small object from toys, as well as beads, balls and seeds in the respiratory tract. This happens during games, when the baby, out of curiosity, pulls everything into his mouth or, even worse, sticks it into the nasal passages, and then when breathing, the foreign body gradually descends into the bronchi.
Most often, in adults and children, foreign objects linger in the larynx without descending into the trachea or further. This is due to the fact that in the area of the vocal cords the larynx narrows, acting as a natural barrier and preventing the passage of foreign objects further.
To prevent such accidents, it is necessary to give small children toys that are missing small parts. Each toy should be checked to see how tightly the eyes and nose are held.
Types of Foreign Objects
Depending on their shape, all foreign objects can be divided into three groups. This is necessary in order to understand the danger of the situation in each specific case and quickly decide on the method of providing emergency care.
- Coin-shaped bodies - this includes coins, buttons, flat batteries, as well as any objects that have a flat, round shape.
- Spherical bodies can be beads, small candies such as Montpensier, vitamins, as well as pieces of poorly chewed apples and sausage. Such products, as a rule, do not have sharp corners, so they can easily fail.
- Bodies resembling a rocker. This is the most dangerous case. Such foreign objects include pieces of dense meat, mainly pork, beef or lamb. Most often, they choke on pieces of shish kebab, which are connected to each other by a thin but durable film.
When choosing an emergency assistance option, it is necessary to take into account what the person has choked on. It should be said that removing pieces of meat from the respiratory tract is the most problematic. Here you have to resort to emergency medical care.
You need to understand that even the smallest object with sharp edges that gets into the respiratory tract can be fatal for a person.
Clinical picture
The main symptoms of a foreign body entering the respiratory tract include the following conditions:
- intense coughing. In this way, the body tries to clear the airways and get rid of the cause of irritation;
- breathing is very difficult, and in many cases the victim is not able to breathe at all. This is explained by the fact that the lumen of the larynx becomes very narrow or completely blocked;
- speech is impaired; most often, when a foreign body enters the larynx, a person cannot speak clearly. If a foreign object affects the vocal cords, then any attempt to say something ends in a violent cough;
- there is severe tearing of the eyes;
- the face and neck become very red, and in some cases become bluish. This occurs due to a lack of oxygen, and also due to the fact that you have to put in too much effort to breathe;
- breathing may be severely impaired or completely absent. In the latter case, the person loses consciousness.
If in such conditions a person is not provided with timely assistance, then there is a high probability that everything will end in death.
Sometimes people around you think that the person is joking and start laughing. However, the victim is not laughing at all, since suffocation can occur in just a few minutes.
First aid if a foreign body enters the respiratory tract
Most often, if foreign bodies enter the respiratory tract, there are only a few minutes during which assistance can be provided. Sometimes the life of a choking person depends on the efficiency and awareness of the people who surround him. After all, when minutes count, you may not be able to wait for the doctors.
If a person chokes on food, those around him try to pat him on the back with a palm to remove a piece of unchewed food from the respiratory tract. This method of providing assistance can also be effective, but only if the technique is performed correctly. The victim should not be hit randomly on the back, but between the shoulder blades, in the projection of the respiratory tract. This should be done with your palm, which is curled into a boat. In this case, the cotton is stronger, it leads to vibration of the airways and the foreign object. The result is a cough and elimination of a piece of food.
This method of removing foreign bodies is permissible only in cases where a person has choked on something small, and this is only manifested by coughing and redness of the face. If the victim shows signs of suffocation and the facial expression has acquired a frightened look, you should resort to other types of help:
- The person providing assistance stands behind the victim and tightly clasps his chest with his hands, while his palms should be clasped. Next, the victim is given the command to exhale short and sharply. At this time, the chest is strongly compressed by the hands, and the victim is tilted forward. Such manipulations should be done until the airways are cleared of the foreign object.
- If a small child is choking, then to remove a piece of food or small objects from the respiratory tract, they lift him upside down and tap him on the back. If a piece of food is not stuck very far, then such actions are quite enough to remove it. But here you need to measure your strength and not trample the child’s legs.
- There is another emergency method that will help remove a foreign body. It can be applied to both adults and children. To do this, the person providing assistance stands on the floor, on one knee, and places the victim on the other so that the lower part of the body is slightly tilted forward. After this, you need to make several blows between the shoulder blades towards the head. Strikes are made with the heel of the palm.
When providing first aid, it is important not to overdo it, so as not to break the victim’s ribs or damage soft tissues.
Sometimes foreign bodies enter the trachea and then move into the bronchi, blocking the lumen. If a foreign object is too small, it can move along the bronchial tree under the influence of air flow and then enter the lungs. This is accompanied by shortness of breath, severe coughing and chest discomfort. In this case, it is impossible to provide assistance at home; the patient should be taken to the hospital, where the foreign object will be removed from the respiratory tract using a bronchoscope.
If a person is unconscious and is not breathing, then it is necessary to dissect the tracheal membrane, but only a doctor can do such a manipulation correctly.
If the foreign body is not promptly removed from the lower respiratory tract, a severe inflammatory process will develop with all the ensuing consequences.
How to help yourself
It happens that a person chokes on food at a time when there is no one at home, and there is nowhere to wait for help. In this case, you can try to help yourself by following these rules:
- Initially, it is important to stop panicking. Panic prevents you from correctly assessing the situation and making the right decision;
- you need to try to take several sharp exhalations. To enhance the effect, clasp the chest with your arms and, as you exhale, make sharp bends forward;
- you need to raise both hands up and try to cough. In this position, the airways expand, and removal of the foreign body will not be difficult.
If such methods do not bring relief, you should contact your neighbors as soon as possible or go outside where passers-by can provide help.
In an emergency situation, many people become confused and forget about the skills they possess. That is why you should put aside panic and try to provide assistance to the victim as quickly as possible. In many cases, a person’s life depends on the correctness of its provision.
This can happen to anyone. Everyone has experienced that unpleasant moment when many people are sitting at the table, and the food or drink goes down the wrong throat. Most often, clearing your throat is enough to stop this incident.
But what to do if within a few minutes it doesn’t get better, you can’t inhale or exhale, your face changes color? People around you rush to help with the desire to pat you on the back.
Now let's imagine: the victim is sitting at a table, the body position is almost vertical, a foreign body is stuck in the respiratory tract. Where does it go when you slap your back? That's right - down the respiratory tract. Such actions are dangerous and can aggravate the situation and even lead to death.
How to act correctly in such situations? Opinions are contradictory. Let's turn to the textbook on first aid.
In the section on foreign body entry into the respiratory tract, recommendations are given: place the victim on his stomach over the knee of the first aid person, strike him on the back.
And not a word about the Heimlich method, which is described in many articles as the only effective one when food enters the respiratory tract. Western cinematography also actively advertises this technique to us.
The question arises, what method should a first aid person turn to when every lost second can lead to death for the victim?
For help in clarification, go to emergency doctor .
— If a person is choking, in what cases are blows to the back used, and in what cases are the Heimlich maneuver used?
- In some cases, tapping the back can provoke the dislocation of a foreign body even lower into the respiratory tract. The lower it is from the vocal cords, the more pronounced the degree of asphyxia (suffocation). In such a situation, ambulance workers are asked to act in accordance with regulations that clearly regulate manipulations with the victim.
1. We start with effleurage (patting, blows between the shoulder blades). You just need to do it correctly so as not to cause harm: place the victim’s torso in a forward position and apply 5 blows between the shoulder blades. The mechanism of this technique is due to the fact that we stimulate and strengthen the cough reflex, which increases expiratory pressure in the respiratory tract. This is necessary to independently remove a foreign body from the respiratory tract.
2. The second stage, if patting is ineffective, is to perform Heimlich maneuver. The victim must be tilted forward, stand behind him, put a hand folded into a fist in the area between the navel and sternum, grab it with the other hand and make 5 sharp pushes inward and upward.
3. If it doesn’t help, we start all over again: 5 blows to the back in the correct body position, then the Heimlich maneuver.
The Heimlich maneuver is different for pregnant women, children, and unconscious people.
Pregnant produce shocks to the chest area.
If a person has lost consciousness , you need to put him on his back, making sure that his head is not turned to the side. It is more convenient to sit on top of him and make the same pushes in the area between the navel and the xiphoid process of the sternum as if the rescuer were standing behind him, in this case using your weight.
If a child is choking, you should not hesitate.
In children, the mucous membrane is very tender, and swelling quickly increases. In a matter of minutes, edema goes from grade 1 to grade 4 and hypoxic coma. You need to immediately call an ambulance or go to the nearest hospital yourself. You can’t be idle while waiting for an ambulance. Provide as much air flow as possible, clear the oral cavity and nasal passages of mucus with a rubber balloon (syringe) or a syringe with a dropper tube. Since there may be reflex vomiting, you need to give a stable lateral position. In children's practice, it is not always recommended to start with tapping. If you do it incorrectly, it can lead to lung rupture or foreign body dislocation.
However, it is no coincidence that the order for ambulance workers prescribes a sequence of actions, starting with blows to the back. This is due to its high effectiveness when done correctly. I can say that if you decide to hit a child in the interscapular area, you need to be careful.
The child is given the following position:
If these actions are ineffective, turn the child onto his back, with his head lower than his body. Make 5 pushes inward and towards the chest in the area below the nipples by one finger. You can do this with one or two hands.
If there was no one nearby If anyone can help, you can help yourself with a modified Heimlich maneuver. The point is that the victim independently reproduces the above described tremors in the epigastric region (a). Or uses available means: the back of a chair, the corner of a table, etc. (b)
Be careful, try not to rush and not be distracted by conversations at the table. Remain calm and follow the instructions clearly if you or someone close to you is choking.
It is, of course, impossible to predict in advance who will manage to choke on what. The tragedy can take place in the dining room or on the street, in a car or on an airplane.
At the same time, it is not at all necessary to talk or laugh with your mouth full. It is enough just to think a little or be very surprised for the unfortunate piece to fall into the wrong throat.
There could just as easily be candy or chewing gum in your windpipe, a pill, or a match held between your teeth.
One can only be amazed at the variety of foreign bodies that enter the larynx and trachea. Sometimes it's hard to imagine what might end up in a person's mouth. This is especially true for children.
REMEMBER! What a foolish baby has in his hands will definitely end up in his mouth.
That's why Adults need to be so careful about what their child plays with.
Depending on their shape, all foreign bodies can be divided into three groups.
Wide and flat objects are classified as coin-shaped bodies(coins, buttons, and any flat rounded plates).
Another group combines items that have spherical shape or pea-shaped (dragees, monpensiers, pellets, balls, unchewed pieces of sausage, cucumbers, potatoes or apples, as a rule, do not have sharp corners and are able to move unhindered over long distances).
And finally, the last group to follow pay special attention, includes foreign bodies shaped like a rocker arm. Most often these are pieces of kebab, bound with a thin but very durable fascial film.
This classification is of fundamental importance for the choice of emergency tactics.
Stages of asphyxia (suffocation)
After a foreign body enters the victim begins coughs a lot and turns red. Before our eyes tears come out, A a coughing fit causes vomiting.
If a person fails to free himself from a foreign body, then, depending on the degree of closure of the lumen of the airway, a sharp cough may be accompanied by stridor breathing with a characteristic wheeze on inspiration.
In this case, the foreign body will move further and further with each breath, severely irritating the mucous membrane of the larynx or trachea.
This quickly leads to their swelling, excessive secretion and accumulation of mucus. The most dangerous: swelling of the vocal folds and spasm of the glottis.
REMEMBER! Even a small object with sharp edges that injure the mucous membrane of the respiratory tract can be fatal.
Any foreign body, irritating the mucous membrane of the larynx and trachea, significantly impairs the patency of the airways.
Even if in the first minutes the choking person’s condition was relatively good, then in the next 10-15 minutes it can worsen significantly.
Redness of the skin of the face and neck is replaced by severe cyanosis (blue discoloration). Coughing movements become less and less frequent.
Adynamia and apathy appear. Very soon the victim loses consciousness. The description of the condition is called blue asphyxia.
Signs of blue asphyxia:
· Loss of consciousness.
· Blue discoloration of lips, face, neck.
· Swelling of neck vessels.
· Vulture and sinking of the supra- and subclavian fossae on inspiration.
· Presence of a pulse in the carotid artery.
In a few minutes this stage will move into the stage pale asphyxia.
The skin will become pale gray in color. The reaction of the pupils to light and the pulse in the carotid artery will disappear.
In other words, clinical death will occur.
Signs of pale asphyxia,
when the victim is in a state of clinical death:
· Pale skin of the face and neck with a grayish tint.
· Wide, light-sensitive pupils.
· Absence of pulse in the carotid artery.
· Sunken supra- and subclavian fossae.
Foreign bodies entering the upper respiratory tract are one of the types of accidents that often result in death within a few minutes.
Be that as it may, someone’s life will depend on the actions of people who happen to be nearby.
REMEMBER! When providing assistance, rely only on your own strength.
The most common mistakes when providing assistance
REMEMBER! Do not do it:
· Begin emergency care by wasting time examining the oral cavity.
· Try to remove the foreign body with your finger or tweezers.
As a rule, under the influence of saliva, the fatal piece of sausage or apple softens so much that even with careful removal, some part of it will definitely come off and, like a vacuum cleaner hose, rush into the larynx. Thus, you will lose your only chance of salvation.
First aid methods
Removing spherical objects
REMEMBER! If a child chokes on a pea, you should immediately turn the baby head down and tap the back several times with your palm at the level of the shoulder blades.
The first thing you should do to help is:
· Turn the victim onto his stomach.
· Throw it over the back of a chair or your own thigh.
· Strike several times with an open palm between the shoulder blades.
If, after several blows between the shoulder blades, the foreign body does not fall to the floor, then you must immediately begin other methods of removing it.
Emergency assistance when hit by coin-shaped objects
REMEMBER! When a coin hits, there is no need to expect success from the previous method: the piggy bank effect is triggered.
In this situation, you need to resort to methods aimed at shaking the chest.
It is necessary to force the foreign body to change its position.
Then there will be hope that, as a result of a strong concussion of the chest, it will either rotate around its axis, freeing up the passage for air, or, moving down the trachea, will eventually end up in one of the bronchi.
Due to anatomical features, the foreign body most often ends up in the right bronchus.
Of course, this will make it difficult to remove it in the future, but it will give the person the opportunity to breathe at least with one lung and, therefore, survive.
Unacceptable!
Hit the back with a fist or the edge of your palm.
There are several ways to shake the chest. The most common of them is tapping your back with your palm.
Short but frequent blows to the interscapular area are most effective. Remember!
Hitting the back can only be done with an open palm.
Another method, more effective, was called the “American Police Method”.
To carry it out, you need to stand behind the victim, wrap your arms around him so that your hands, folded into a lock, are below his xiphoid process, and then with a sharp movement press strongly under the diaphragm and hit your back against your chest.
REMEMBER! A blow to the epigastric region can lead to loss of consciousness and sudden cardiac arrest, so you should not unclench your hands immediately after the blow.
Using this option, you must be prepared for the possibility that the victim will develop clinical death.
All of the above methods can be used if The choking person is conscious.
If he is in a coma, then it should be immediately turn over on your right side and hit your back with your palm several times. But, as a rule, one cannot count on success from such an action.
Food fish and meat bones often enter the pharynx, esophagus and respiratory tract during eating, as well as pins, buttons, small nails and other objects that are taken into the mouth while working. This may cause pain, difficulty breathing, coughing, and even suffocation.
Attempts to cause a foreign body to pass through the esophagus into the stomach by eating crusts of bread, porridge, or potatoes are unsuccessful in most cases, so in any case you must contact a medical facility.
In cases where, during mechanical ventilation, when attempting to inflate the lungs under positive pressure, an obstacle is encountered, despite the fact that the patient’s head is thrown back, the lower jaw is pushed forward, and the mouth is open, a foreign body in the upper respiratory tract can be suspected. If there is no effect, the victim is placed on the table, the head is sharply bent back and the larynx area is examined through the open mouth (Fig. 2.5).
Fig.2.5. Foreign bodies in the respiratory tract:
If a foreign body is detected, it is grabbed with tweezers, fingers and removed. The victim should be taken to a medical facility.
To quickly open your mouth, three techniques are used:
A - technique using crossed fingers with a moderately relaxed lower jaw. Insert your index finger into the corner of the victim's mouth and press in the direction opposite to the upper teeth. Then the thumb is placed against the index finger along the line of the upper teeth and the mouth is opened;
B - “finger behind teeth” technique for a fixed jaw. Insert the index finger between the cheeks and teeth of the victim and wedge its tip behind the last molar;
B - "lifting the tongue and jaw" technique for a sufficiently relaxed lower jaw. Insert the thumb into the patient’s mouth and throat and at the same time lift the root of the tongue with its tip. With other fingers, grab the lower jaw in the chin area and push it forward.
After successful removal of the foreign object and in the absence of breathing, it is necessary to continue the mechanical ventilation procedure.
At foreign body entering the respiratory tract The provision of first aid to the victim is as follows: the victim is placed on his stomach with a bent knee, his head is lowered down as low as possible and the chest is shaken with hand blows on the back, while the epigastric region is compressed.
If the cough continues, you should try using the combined action of gravity and patting. To do this, help the victim bend down so that his head is lower than his lungs, and sharply slam him with your palm between the shoulder blades. If necessary, you can do this three more times. Look into your mouth and... if a foreign body pops out, remove it. If not, try to push it out with air pressure, which is created by sharp thrusts into the stomach. To do this, if the victim is conscious and can stand, stand behind him and wrap your arms around his waist. Make a fist with one hand and press it to your stomach with the thumb side. Make sure your fist is between your belly button and the lower edge of your sternum. Place your other hand on your fist and sharply press up and inside your stomach (Fig. 2.6).
Do this up to four times if necessary. Pause after each press and be prepared to quickly remove anything that may come out of your windpipe. If the cough does not stop, alternate four slaps on the back and four pressures on the stomach until the foreign body can be removed. If the cough continues, alternate hand thrusts into the victim's stomach with slapping on the back.
Rice. 2.6. Removing a foreign body from the respiratory tract
If the victim is unconscious, then in order to press on his stomach, turn him on his back. Kneel so that it is between your legs, place your hand between your navel and sternum, and the second hand on the first. Make four clicks as described above. If the interference persists and the patient has stopped breathing, it is necessary to begin artificial respiration and cardiac massage.
If the airways are completely closed, asphyxia has developed and it is impossible to remove the foreign body, the only rescue measure is emergency tracheotomy. The victim should be immediately transported to a medical facility.
Foreign bodies in the respiratory tract are most often observed in children. If a child inhales a small object, ask him to cough sharper, harder - sometimes, in this way, it is possible to push the foreign body out of the larynx. Or place your baby in your lap upside down and pat him on the back. Try to grab a small child firmly by the legs and lower him upside down, also patting him on the back (Fig. 2.7).
Fig.2.7. Removing a foreign body from a child's respiratory tract
If this does not help, urgent medical attention is needed, since a foreign body can enter the bronchi, which is very dangerous. Special emergency measures are needed to remove it.