Today, we will consider what to do when a child or an adult suffocates, depending on the causes of the choking, how to properly provide the first urgent help to children and adults at home in various emergency and dangerous situations.
Choking is the inability to provide the human body, and any living being, with oxygen for the realization of normal vital functions and the performance of vital functions.
Causes of suffocation are manifold:
- foreign body entry into the trachea;
- stenosis of the larynx due to disease or trauma;
- Absorption abscess
- Bronchiolitis
- Bronchial asthma
- Other causes of asphyxiation: plastic bags, pillows, sand, indoor smoke, drowning. Of course, this article bears general information, some articles of the article can be performed only by medical workers, but also to ordinary people without medical education, it is useful to get acquainted with the contents of the publication for information, after all, we can do quite some things, still we need to save a friendfriend!
CONTENTS
Choking: first aid what to do when a person suffocates
People are choking not only when foreign bodies get intoraheyu, but in the case where the airways are blocked out.
Choking in stenosis of the larynx
Stenosis of the larynx is sometimes differentiated from bronchial asthma( it is characterized by expiratory dyspnea), heart failure, hysteria. With stenosis of the trachea, the voice is not disturbed, the patient's head tilts forward.
Emergency care
The choice of method of treatment is primarily determined by the stage of stenosis, and the second - the cause that caused stenosis. Treatment can be conservative and surgical. With the first two stages of stenosis of the larynx, treatment is aimed at eliminating the pathological process that caused suffocation.
Treatment of laryngeal edema includes dehydration, hyposensitizing, sedative, distracting procedures and usually consists of the following appointments. Intravenous: 40% glucose solution - 20 ml, 10% solution Calcium chloride - 10 ml, 5% solution Sodium ascorbate - 5 ml, 2.4% solution of Euphyllin - 5-10 ml, solution of Prednisolon50 mg in 10 ml of water for injection. Intramuscularly: 1% solution of Diphenhydramine - 2 ml( 2.5% solution of Pipolphen - 2 ml or other antihistamine).
Distracting procedures
Assigned in the absence of hyperthermia, cardiovascular insufficiency, they include hot foot baths, mustard plasters on the chest and calf muscles. Effective inhalation of moistened oxygen, as well as with alkaline, hyposensitizing and antispasmodic agents.
With the purulent process, is administered antibacterial drugs. It is necessary to perform an opening of the abscess in the larynx or in adjacent organs in a hospital.
In diphtheria of the larynx, the introduction of antidiphtheria serum is at the forefront.
For burn edema of the larynx it is necessary to carry out anti-shock measures - subcutaneous injection of 1-2 ml of 2% solution of Promedol or 1% solution of Omnepona.
In the III and IV stages of stenosis, surgical treatment, usually tracheostomy, is always used. Urgently produce a conicotomy or a cryoconicotomy.
In acute laryngotracheitis in children, restoration of the laryngeal lumen begins with prolonged intubation with thermoplastic tubes.
Treatment of acute stenosis of the larynx should always be performed in a hospital. An urgent hospitalization in the ENT, resuscitation or surgical department is indicated, since at any time tracheostomy may be required.
Asphyxia and dyspnea in children
Three main syndromes are distinguished in respiratory diseases:
- dyspnea( dyspnoea, tachypnea, forced breathing, jerky breathing);
- signs of shortness of breath( snoring, wheezing, inspiratory and expiratory stridor);
- signs of respiratory failure( cyanosis with exercise or persistent, respiratory acidosis).
Foreign bodies of the respiratory tract
Various items enter the respiratory tract, including:
- cereal grains,
- coins,
- pins,
- food masses,
- buttons,
which can be found in any part of the respiratory tract:
- nasal passages,
- trachea,
- larynx,
- bronchi.
Timely not recognized, they can mimic the symptoms of croup, bronchial asthma, pneumonia, etc. If foreign bodies get into contact, the following clinical forms of asphyxiation may develop:
- fulminant,
- acute,
- subacute.
Symptoms
The fulminant form occurs with complete obstruction of the respiratory tract and is characterized by sudden onset of asphyxia, accompanied by protrusion of eyeballs, sharp cyanosis, convulsions.
In acute and subacute flow is characterized by a sudden development of an attack of persistent cough, breathing is difficult. The child tries to inhale, strains, but the breath is ineffective, which causes extreme anxiety. There is a cyanosis of the lips, which then spreads to the entire face. In the future, the patient's condition depends on the size of the foreign body, its location in the airways and the mechanical effect on them.
If foreign bodies remain in the nasal passages, after a while there are malodorous purulent or spotting, swelling of the nasal mucosa.
When a foreign body enters the bronchi percussion, dullness of the sound, weakening of the voice jitter and breathing, possible development of pneumonia, lung abscess, bronchiectasis.
Foreign body recognition is not difficult with sudden attack of a cough, absence of fever and catarrhal phenomena. Foreign bodies can cause a change in voice - hoarseness and aphonia.
Emergency Care
Under normal conditions, when you are upside down( short-term!), A back tap is performed. In a lightning-fast form, the upper tracheostomy, conicotomy or direct laryngoscopy( only possible with an artificial respiration apparatus) is indicated. In acute and subacute flow, the method of choice is pancreatic oronhoscopy.
Hospitalization in all cases of emergency - in the department of otolaryngology.
Hypertrophic abscess
The cause of suppuration of the deep periputic lymph nodes and the cellulose around them with the formation of a purulent cavity can be diseases of the pharynx, middle ear, posterior nasal, eustachian tubes, tonsillitis, adenoiditis, common infections such as measles, scarlet fever, influenza and others.
Symptoms of
Characterized by acute onset with high fever, general anxiety, insomnia.
Swallowing is difficult due to pain and mechanical obstruction, which is why the child refuses to eat.
The voice acquires a nasal "nasal" hue, the head is slightly thrown back and to the sore side.
Breathing is snoring, difficult, especially in a horizontal position, swelling, tenderness of the lymph nodes are noted.
Dyspnea rapidly builds up, goes into choking and can result in asphyxia and death.
On examination, edema of the posterior wall and protrusion of it are noted, often abscess is accompanied by trismus, increased salivation, abdominal pain. When palpation is determined by fluctuation. In the analysis of urine - sharply increased ESR, leukocytosis. It is necessary to differentiate from acute stenosing laryngo- bronchitis, foreign body, pneumonia. The diagnosis is confirmed during pharyngoscopy or using a diagnostic puncture.
Emergency care
Antibiotic therapy, dry heat on the neck, opening of the abscess is performed in the hospital with subsequent antibiotic therapy.
Hospitalization urgent in the otorhinolaryngological or surgical department.
Bronchiolitis
At the heart of the disease is the inflammation of the terminal parts of the bronchial tree( bronchioles), caused by a viral or viral-bacterial infection.
Symptoms of
Characteristic of acute onset, high temperature up to 40 degrees, tracheal croupy cough, inspiratory dyspnea, changing into expiratory, changes the rhythm of breathing, wheezing, cyanosis of the lips.
The face is puffy, blowing of the wings of the nose is observed. Periodically, there are stops of breathing with a sharp increase in cyanosis. Above the lungs, a tympatic shade of pulmonary sound, stiff breathing, scattered dry and finely bubbling wet wheezing are determined. There is a tachycardia, heart tones are muffled, sometimes there are signs of an acute pulmonary heart, an arrhythmic pulse, a low filling. The abdomen is upset.
Owing to oxygen deficiency, convulsions sometimes appear. The diagnosis is confirmed by radiography. Differentiate follows from attacks of bronchial asthma, bronchitis, miliary tuberculosis.
Emergency care
Strictly bed rest, a constant influx of fresh air, should take the child to the veranda, balcony, change the position in the bed and periodically take the child in his arms.
Oxygen therapy with 40% oxygen / air mixture is shown.
Intravenous injection of 0.05% solution of Strophantine: children under 6 months - 0.05-0.1 ml, 1-3 years - 0.1-0.2 ml, 4-7 years - 0.2-0, 3 ml, older than 7 years - 0.3-0.4 ml to 3-4 times a day in combination with 10 ml of 10-20% glucose solution.
From spasmolytic funds prescribed 2.4% solution of Eufillina intravenously: children under 6 months - 0.3 ml, up to 12 months.- 0.4 ml, 1-2 years - 0.5 ml, 3-4 years - 1 ml, 5-6 years - 2 ml to 3 times a day, subcutaneously or intramuscularly injected 10% solution of Caffeine every 6 hours: children under 1 year - 0.25 ml per injection, 1-2 years - 0.25-0.4 ml, 3-6 years - 0.3-0.5 ml, 5% solution Ephedrine: children up to6 months - 0.04 ml, 7-12 months - 0.1 ml, 1-4 years - 0.2 ml, 5-6 years - 0.25 ml 3 times a day;prednisolone - 1-2 mg / kg, vitamins B and B6 subcutaneously or intramuscularly;ascorbic acid - up to 500 mg / day;antibiotics( Penicillin - 100,000 units /( kg x day), Ceporin - 15-30 mg / kg).Drip injection of a 5-10% solution of glucose and an isotonic solution of sodium chloride is shown.
Hospitalization in all cases in the somatic or infectious division.
Bronchial asthma
Often begins in the first years of life. The disease is predisposed to frequent ARVI, chronic inflammatory processes in the nasopharynx, hereditary burden, instability of the nervous system, and more.
Emergency care
For mild and short-term attacks, treatment can be carried out at home.
Emergency interventions are reduced to creating a calm environment, wide access to fresh air.
Showing semi-sitting or sitting position, hot foot or hand baths at a water temperature of 37 to 42 degrees for 10-15 minutes, overlapping cans, inhalation with Iazrin in the form of 0.5% and 1% aqueous solution for 0.5-1 ml per inhalation 2-4 times a day or inside 1-5 mg( under the tongue), with Alupent - 1-2 breaths.
Assign bronchodilators as well:
- Ephedrine - for children under 1 year 0,002-0,003 g, 2-5 years - 0,003-0,01 g, 6-12 years - 0,01-0,02 g for taking 2-3 times inday;
- Teofillin to children 2-4 years - 0,01-0,04 g, 5-6 years - 0,04-0,06 g, 7-9 years - 0,05-0,075 g, 10-14 years - 0,05-0,01 g for reception 3-4 times a day;
- Teofedrine or Antastmann for one-quarter or half of the tablet 1-2 times a day;
- Solutan 1 drop per 1 year of life 3-4 times a day on milk.
Antihistamines:
- Dimedrol for children under 1 year - 0.002-0.005 g, 2-5 years - 0.005 - 0.015 g, 6-12 years - 0.015-0.03 g for taking 2 times a day;
- Pipolphene for children under 6 years - 0.008-0.01 g, over 6 years - 0.012-0.015 g 2-3 times a day;
- Suprastin - 0,006-0,025 g 2 times a day;
- Tavegil - one second part or one tablet 2 times a day.
Other causes of
asphyxiation Suffocation can come from inhaling smoke from a fire, when covering a child with a pillow, when playing in a sandbox and getting sand particles in the respiratory tract, when putting a polyethylene bag on the head.
Plastic bags
Children love everything unusual. Playing with plastic bags, they often pull them on their heads, and then they can not take off and suffocate. Throughout the world, there are many deaths of children for this reason. Therefore, parents should hide children's plastic bags and sticky film, which is used for packing the goods.
Older children and teenagers sometimes suffocate in a plastic bag, catching "buzz" from inhaling vapors of various solvents. Parents should carefully monitor their children and not allow games with such life-threatening objects.
Pillows
Small children can suffocate if they are sleeping face down on a soft cushion. Parents should be aware of the fact that can not give children a soft pillow at least until they are one year old. The cushion on which the child sleeps must be small and stiff, and if the pillow is ordinary, then it is better to put it not under the head, but under the mattress.
Sand
Playing on the beach or in the sandbox, children like to fall asleep with each other with sand. Sometimes sand covers the entire body, including the face. Parents should always be careful to ensure that children are not very addicted to such games, since choking can occur when the sand falls on the face. Especially it can be dangerous when children play on a construction site where there is a mountain of sand( or land) and a landslide can occur.
Smoke from the smoke, fire!
In case of fire, both children and adults are at risk.
Before entering the burning house to save someone, you must do three things:
- Make sure that someone sees you.
- Call the fire brigade.
- Touch the door handle of the door where you are going to enter. If the pen is hot, you will not save anybody, but you will die in smoke and flame. In addition, you will let oxygen into the burning room, and the flame will explode with a fireball that will sweep away and destroy all those around you.
If the flames have not yet seized the room and the door handle is cool, then, trying to save someone, do not rush into the fire headlong, and first call for help and do a few things that will help you survive:
- before entering the room, wind your nose and mouth with something moist( handkerchief, rag, towel);
- act without panic, as it will only harm your actions;
- do not run into the room, but squat or even flat and move forward almost creeping - a few centimeters above the floor can be free from smoke and you can breathe;
- do not light a match or light, it will not give you anything and, in addition, an explosion may occur;
- in a room embraced by a flame, you can not always find the door to go outside( especially if you inhale the carbon monoxide contained in the smoke and lose control of yourself);
- before entering the room, think about where the child could hide - usually children in a fire find such places to hide, which you will never think about. Most often they hide under the mattress, under the bed, in the closet or wardrobe, burrow into bed linens, etc.
If you managed to get the child out of the burning room, your further actions should be as follows:
- undress the child or unbutton his clothes. Provide fresh air to the respiratory tract of the child;
- put the baby on its side, as it is likely to be nauseated;
- soothe the child and do not leave him alone;
- if the child is unconscious, make sure that he is breathing;
- if breathing is not present, begin to do artificial respiration and indirect heart massage;
- inspect the child's body and make sure that there are no burns on it;
- , in the presence of burns, take first aid measures for burns. It is better to get acquainted with them in advance.
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In this program, Dr. Komarovsky will tell you what to do to parents in situations when the child "has something swallowed"( the foreign body got into the gastrointestinal tract, got stuckin the throat, etc.) and when something fell into my ear. Simple and understandable algorithms of action and a list of situations when a doctor can not do without.
Source: YNGorgov. Official and traditional medicine. The most detailed encyclopedia.- Moscow: Izd-vo Eksmo, 2012.
