呛噎者的急救
呛噎者的急救
呛噎者的急救
如果一个人发生呛噎，不能说话、不能哭、不能强笑，先背击 5 下，然后腹推 5 下。
如何对自己进行腹推（也称为海姆利希手法）
如何对自己进行腹推（也称为海姆利希手法）
如何对自己进行腹推（也称为海姆利希手法）
要对自己进行腹推（也称为海姆利希手法），请将拳头放在肚脐上方。另一只手握住拳头，在坚硬的表面弯下腰。向上、向内推拳头。
当有异物卡在喉咙或气管中阻断空气流动时，就会发生呛噎。对成年人来说，通常由一块食物所引起。幼儿经常被小异物噎住。呛噎威胁生命。它切断了通往大脑的氧气。如果您或他人发生呛噎，应尽快进行急救。
注意呛噎的下列特征：
- 单手或双手紧抓喉咙
- 表情惊慌、震惊或困惑
- 无法说话
- 呼吸紧张或呼吸作响
- 尝试呼吸时发出短促尖叫声
- 无力或剧烈咳嗽
- 皮肤、嘴唇和指甲的颜色变成蓝色或灰色
- 失去意识
如果呛噎者可以用力咳嗽，就让其继续咳嗽。
咳嗽可能会自然地清除卡住的异物。
如果呛噎者无法咳嗽、说话、哭泣或用力大笑，请对其进行急救。
美国红十字会建议采取以下步骤：
- 背击五下。如果呛噎者是成人，紧挨其身后站于侧面。对于儿童，则跪于身后。将手臂横放在呛噎者的胸前，支撑其身体。使其弯腰，脸朝地面。用掌根在其肩胛骨之间背击五下。
- 腹推五下。如果背击不能移除卡住的异物，则进行五次腹推，也称为海姆利希手法。
- 交替进行五次背击和五次腹推，直到吐出堵塞物。
有些资料只教腹推。如果没学过背击，可以不用这个技巧。两种方式均可用于成人和 1 岁以上的儿童。
如要给别人腹推，请：
- 站在其身后。对于儿童，则跪于身后。一只脚位于另一只脚稍前位置，以保持平衡。手臂环绕在对方腰上。让对方稍微向前倾。
- 一只手握拳。拳头放在对方肚脐上方。
- 另一只手握住握拳的手。快速向上向内用力按压胃部（也称腹部），如同要抬起对方。对儿童来说，按压要轻但要稳，以免损伤内部器官。
- 腹推五下。检查堵塞物是否已被清除。根据需要，重复上述步骤。
如果您是唯一的救援者，请首先进行背击和腹推。然后拨打 911 或当地急救电话寻求帮助。如有其他人在场，您可以在实施急救的同时让其他人拨打电话。
如果患者失去意识，请实施胸部按压和人工呼吸等标准心肺复苏术（CPR）。
如果患者是孕妇，或者您无法用手臂抱住腹部，请采取胸部推压：
- 把手放在胸骨底部，略高于最下方肋骨的连接处。
- 快速用力推压胸腔。动作与海姆利希手法相同。
- 重复进行，直到将堵塞物从气道中清除为止。
清理无意识患者的气道：
- 将其放倒在地面上，背部着地，双臂放在两侧。
- 清理气道。如果您能看到异物，把一根手指伸进嘴里，扫出异物。在看不到异物的情况下，切勿用手指去清除。您有可能将堵塞物推到气道更深处。这对幼儿来说非常危险。
- 如果患者仍然没有反应，就开始进行 CPR。如果气道仍然被堵塞，请使用胸外按压，例如 CPR 中使用的胸外按压，以清除卡住的异物。每个周期只进行两次人工呼吸。频繁检查嘴里的异物。
清理 1 岁以下呛噎婴幼儿的气道：
- 坐好，将婴儿面朝下放在您的前臂上。将您的前臂放在您的大腿上。握住婴儿的下巴和下颌以支撑头部。将头部置于比躯干更低的位置。
- 在婴幼儿的背中央拍打五次，动作要轻但要稳。使用掌根完成此动作。将手指朝上，以免碰到婴儿的后脑勺。重力作用和背击应该会排出堵塞物。
- 如果还未开始呼吸，将婴儿的脸朝上放在您的前臂上。将您的手臂放在您的大腿上。将婴儿的头部置于低于躯干的位置。
- 用您的手指对其胸部进行五次轻柔但稳健的按压。将两个手指放在乳头线下。压下约 4 厘米（1.5 英寸）。两次按压之间，让胸部抬升。
- 如果还未开始呼吸，则重复背击和胸部按压。致电寻求紧急医疗救助。
- 如果气道通畅，但婴儿没有开始呼吸，则开始对婴儿进行 CPR。
如果您呛噎时身边没有人：
立即拨打 911 或当地的急救电话。然后，给自己做腹推，也叫海姆利希手法，以清除卡住的异物。
- 一手握拳，放在肚脐稍往上的位置。
- 用另一只手握住握拳的手。
- 在坚硬的表面上弯下腰。桌面或椅子就行。
- 向上向内推拳头。
要为这些情况做出准备，可以在认证的急救培训课程上学习海姆利希手法和 CPR。
When to seek emergency help
If you're the only rescuer, give back blows and abdominal thrusts first. Then call 911 or your local emergency number for help. If another person is there, have that person call for help while you give first aid.
If you're alone and choking, call 911 or your local emergency number right away. Then, give yourself abdominal thrusts, also called the Heimlich maneuver, to remove the stuck object.
Symptoms
Watch for these signs of choking:
- One or both hands clutched to the throat.
- A look of panic, shock or confusion.
- Inability to talk.
- Strained or noisy breathing.
- Squeaky sounds when trying to breathe.
- Cough, which may either be weak or forceful.
- Skin, lips and nails that change color turning blue or gray.
- Loss of consciousness.
Treatment
Infant
To clear the airway of a choking infant younger than age 1:
- Sit and hold the infant facedown on your forearm. Rest your forearm on your thigh. Hold the infant's chin and jaw to support the head. Place the head lower than the trunk.
- Thump the infant gently but firmly five times on the middle of the back. Use the heel of your hand. Point your fingers up so that you don't hit the back of the infant's head. Gravity and the back thumps should release the blockage.
- Turn the infant faceup on your forearm if breathing hasn't started. Rest your arm on your thigh. Place the infant's head lower than the trunk.
- Give five gentle but firm chest compressions with your fingers. Place two fingers just below the nipple line. Press down about 1 1/2 inches. Let the chest rise between each compression.
- Repeat the back thumps and chest compressions if breathing doesn't start. Call for emergency medical help.
- Begin infant CPR if the airway is clear but the infant doesn't start breathing.
Child and adult
If a choking person can cough forcefully, let the person keep coughing.
Coughing might naturally remove the stuck object.
If a person can't cough, talk, cry or laugh forcefully, give first aid to the person.
The American Red Cross recommends the following steps:
- Give five back blows. Stand to the side and just behind a choking adult. For a child, kneel down behind. Place your arm across the person's chest to support the person's body. Bend the person over at the waist to face the ground. Strike five separate times between the person's shoulder blades with the heel of your hand.
- Give five abdominal thrusts. If back blows don't remove the stuck object, give five abdominal thrusts, also known as the Heimlich maneuver.
- Alternate between five blows and five thrusts until the blockage is dislodged.
Some sources only teach the abdominal thrust. It's OK not to use back blows if you haven't learned the back-blow technique. Both approaches are acceptable for adults and children older than age 1.
To give abdominal thrusts to someone else:
- Stand behind the person. For a child, kneel down behind. Place one foot slightly in front of the other for balance. Wrap your arms around the waist. Tip the person forward slightly.
- Make a fist with one hand. Put it just above the person's navel.
- Grasp the fist with the other hand. Press into the stomach, also called the abdomen, with a quick, upward thrust — as if trying to lift the person up. For a child, use gentle yet firm pressure to avoid damaging the internal organs.
- Give five abdominal thrusts. Check if the blockage has been removed. Repeat as needed.
If you're the only rescuer, give back blows and abdominal thrusts first. Then call 911 or your local emergency number for help. If another person is there, have that person call for help while you give first aid.
If the person becomes unconscious, start standard cardiopulmonary resuscitation (CPR) with chest compressions and rescue breaths.
To clear the airway of an unconscious person:
- Lower the person onto the floor, with the back on the floor and arms to the sides.
- Clear the airway. If you can see the object, reach a finger into the mouth to sweep out the object. Never finger sweep if you can't see the object. You risk pushing the blockage deeper into the airway. This is very risky with young children.
- Begin CPR if the person still doesn't respond. If the airway is still blocked, use chest compressions such as those that are used in CPR to remove the stuck object. Only use two rescue breaths per cycle. Recheck the mouth regularly for the object.
Pregnant person or someone you can't get your arms around
If the person is pregnant or if you can't get your arms around the stomach, give chest thrusts:
- Put your hands at the base of the breastbone, just above the joining of the lowest ribs.
- Press hard into the chest with a quick thrust. This is the same action as the Heimlich maneuver.
- Repeat until the blockage is removed from the airway.
Yourself
If you're alone and choking:
Call 911 or your local emergency number right away. Then, give yourself abdominal thrusts, also called the Heimlich maneuver, to remove the stuck object.
- Place a fist slightly above your navel.
- Grasp your fist with the other hand.
- Bend over a hard surface. A countertop or chair will do.
- Shove your fist inward and upward.
May 24, 2024
- American Red Cross Training Services. Choking. In: First Aid/CPR/AED Participant's Manual. The American Red Cross; 2021. https://www.redcross.org/store/first-aid-cpr-aed-participants-manual/754100.html. Accessed Aug. 22, 2022.
- Auerbach PS, et al., eds. Field Guide to Wilderness Medicine. 5th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Aug. 25, 2022.
- Ruiz FE. Airway foreign bodies in children. https://www.uptodate.com/contents/search. Accessed Aug. 25, 2022.
- AskMayoExpert. Stridor emergency assessment. Mayo Clinic; 2021.
- Shepherd W. Airway foreign bodies in adults. https://www.uptodate.com/contents/search. Accessed Aug. 25, 2022.
- Moll V. Airway establishment and control. Merck Manual Professional Version. https://www.merckmanuals.com/professional/critical-care-medicine/respiratory-arrest/airway-establishment-and-control. Accessed Aug. 25, 2022.
- Tintinalli JE, et al., eds. Resuscitation of children. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw Hill; 2020. https://accessmedicine.mhmedical.com. Accessed Aug. 25, 2022.