A Victim With A Foreign Body Airway Obstruction Becomes Unresponsive

A Victim with a Foreign Body Airway Obstruction Becomes Unresponsive: A Comprehensive Guide

Foreign body airway obstruction (FBAO) is a life-threatening emergency that can rapidly lead to unconsciousness and death if not addressed promptly. This article provides a comprehensive guide for handling a victim experiencing FBAO who has become unresponsive. Understanding the steps involved, from recognizing the signs to performing life-saving maneuvers, is crucial for saving a life.

Recognizing the Signs of a Foreign Body Airway Obstruction

Before addressing the unresponsive victim, it’s critical to understand how FBAO presents itself. Early recognition is key to effective intervention. Signs of FBAO in a conscious victim include:

• Sudden coughing or choking: This is often the first and most obvious sign. The victim may be clutching their throat.
• Inability to speak or breathe: The victim may be unable to produce sounds or take a full breath.
• Wheezing or stridor: A high-pitched whistling sound during breathing indicates airway narrowing.
• Cyanosis: Bluish discoloration of the lips and fingertips, indicating a lack of oxygen.
• Distress and anxiety: The victim will exhibit clear signs of panic and discomfort.

If the victim becomes unresponsive, these signs may progress rapidly, including:

• Loss of consciousness: The most critical sign indicating a complete airway blockage.
• Absence of breathing or gasping: The victim may show only infrequent, shallow gasps.
• Loss of pulse: This indicates cardiac arrest is imminent.

Initial Assessment and Action: The ABCs

Once the victim becomes unresponsive, immediately initiate the primary assessment using the ABCs: Airway, Breathing, and Circulation.

A - Airway:

1. Check for responsiveness: Gently tap the victim's shoulders and shout, "Are you okay?"
2. Open the airway: If the victim is unresponsive, open the airway using the head-tilt-chin-lift maneuver. Avoid this maneuver if you suspect a neck injury; use the jaw-thrust maneuver instead.
3. Look, listen, and feel for breathing: Look for chest rise and fall, listen for breath sounds, and feel for airflow against your cheek.

B - Breathing:

1. Assess breathing: If the victim is not breathing normally, begin CPR immediately. In cases of suspected FBAO, check the mouth for a visible obstruction.

C - Circulation:

1. Check for a pulse: Check for a carotid pulse (in the neck) for no more than 10 seconds. If no pulse is detected, begin chest compressions.

Performing CPR and Abdominal Thrusts (Heimlich Maneuver) on an Unresponsive Victim

The approach to CPR in an unresponsive victim with suspected FBAO differs slightly from standard CPR.

1. Begin chest compressions: Initiate chest compressions at a rate of 100-120 compressions per minute and a depth of at least 2 inches.

2. Look inside the mouth: After each set of 30 chest compressions, open the victim’s mouth and check for a visible obstruction. If you see an object, attempt to remove it with your finger, sweeping it from the back of the throat towards the mouth. Avoid blind finger sweeps.

3. Deliver breaths: After removing any visible object and checking for any lingering obstruction, give two rescue breaths. Look for chest rise to ensure breaths are effective.

4. Continue cycles of chest compressions and breaths: Continue CPR cycles (30 compressions followed by two breaths) until:

   • Advanced medical help arrives and takes over.
   • The victim starts to breathe normally.
   • You are too exhausted to continue.

Important Note: In cases of suspected FBAO in an unresponsive adult, abdominal thrusts (Heimlich maneuver) are not recommended during CPR. Focus on chest compressions and rescue breaths, while carefully checking the mouth for visible obstructions after every set of compressions. Abdominal thrusts can cause further damage to the victim's internal organs and should only be used on a conscious choking victim.

When to Call Emergency Medical Services (EMS)

Calling EMS should be your first priority after determining the victim is unresponsive. Every second counts in these situations. Do not delay calling EMS while performing CPR or other life-saving measures.

Provide the dispatcher with the following information:

• Location of the incident: Be as precise as possible.
• Victim's condition: Explain the situation clearly, including that the victim is unresponsive and suspected of having a foreign body airway obstruction.
• Your actions taken: Inform the dispatcher of the CPR in progress.
• Any other pertinent information: Mention any known allergies or medical conditions.

Post-Resuscitation Care

Once the victim regains consciousness or if emergency medical services arrive and take over, continue to monitor their vital signs. The victim may require:

• Supplemental oxygen: To aid in recovery from oxygen deprivation.
• Advanced airway management: If necessary, a more advanced airway support method may be required such as endotracheal intubation or a supraglottic airway device.
• Further medical evaluation: The victim will need to be evaluated for any potential complications from the FBAO, including lung damage or cardiac issues.

Prevention of Foreign Body Airway Obstruction

Prevention is always the best approach. Several strategies can significantly reduce the risk of FBAO:

• Proper supervision of children: Young children should always be supervised while eating or playing with small objects.
• Cut food into small pieces: This reduces the risk of large food pieces obstructing the airway.
• Avoid eating while running or playing: Distraction can lead to accidental choking.
• Chew food thoroughly: Proper chewing helps break down food into smaller, more manageable pieces.
• Encourage good eating habits: Teach children to avoid talking with their mouths full.

Conclusion

A foreign body airway obstruction leading to unresponsiveness is a critical medical emergency. Prompt recognition, immediate CPR initiation, and a rapid response from emergency medical services are crucial for improving the chances of survival. Familiarizing oneself with the procedures outlined in this guide can empower individuals to save lives in such situations. Remember that early intervention is key; act quickly and decisively. Proper training in CPR and first aid is strongly recommended for all individuals. This knowledge empowers you to be prepared to handle such emergencies effectively and confidently. Regular refresher courses are essential to maintain proficiency in life-saving techniques.