First Aid for Choking Including Dechoker Rescue Device

First Aid for Choking Including Dechoker Rescue Device December 2016 1

First Aid for Choking Today you’ll learn: • • • Prevention of Choking and Awareness Causes of Choking Best Practices (Prevention) Risks of Choking Signs and Symptoms of Choking Abdominal Thrusts (Standing) Abdominal Thrusts (Lying Down) Abdominal Thrusts (Wheelchair) Anti-Choking Device (ACD) – Dechoker Procedures and Protocol when using the Dechoker 2016 © Dechoker LLC. These materials are intended to assist employees in the use of training, and is only a general guide to the program. This material is to be used for training purposes only. Some of the procedures, field entries, and other operating procedures as described within these pages may be different than actual on-site procedures. Therefore, application should not be made without consideration of specific circumstances. This training does not create any legal obligations to any user and should not be considered as legal advice. 2

First Aid for Choking Prevention of Choking and Awareness Training According to the National Safety Council, every year about 3, 000 adults die because they accidentally inhale rather than swallow food. • 3 Choking is the #5 cause of accidental deaths in the United States behind motor vehicle incidents, poisoning, falls and fires. Choking is a common and potentially life-threatening form of emergency.

First Aid for Choking Causes of Choking blocks air from getting into the lungs. Causes of Choking: • Physical blockage of the airway by food, fluid, or a solid object. • Vomiting or regurgitation from Gastro Esophageal Reflux Disease (GERD). • Overfeeding through a feeding tube. 4

First Aid for Choking Best Practices (Prevention) • We work to assess everyone we support for risk of choking. • Anyone at risk should be seen by his/her physician, speech therapist and dietitian for a swallow study. • All modified diets should be addressed on the person’s support plan and ALL staff working with them should be aware of such. • Assure that staff is appropriately trained on the proper diet order and competent in preparing the food and/or fluid to the required consistency and proper feeding protocol. • Always promote safe eating habits. • Closely monitor and never leave people we support alone during mealtime, who are at risk for choking. 5

First Aid for Choking Risks of Choking • Certain foods have a higher risk for choking: • Hot dogs, marshmallows, peanut butter, grilled cheese, gooey gel candies, grapes, nuts, chewing gum, carrots, chunks of meat, apples, hard candies. • Individuals with pica behavior (eating non-food items) are also at risk for choking on small objects or inedible items. • Individuals who steal or hoard food are also at risk for choking because of their need to eat and swallow quickly. 6

First Aid for Choking Signs and Symptoms of Choking The universal sign for choking is hands clutched to the throat. Most of the people we support will not be able to indicate in this manner or verbally tell us they are choking, some typical non-verbal signs are: • Inability to talk • Skin, lips and nails turning blue • Difficulty breathing or noisy breathing, and wheezing • Panicked look/appearance • Inability to cough forcefully • Gagging 7 • Eventual loss of consciousness

First Aid for Choking First Aid and Emergency Treatment If choking does occur, the American Red Cross recommends a "five-and-five" approach to delivering first aid: • Give 5 back blows. First, deliver five back blows between the person's shoulder blades with the heel of your hand. • Give 5 abdominal thrusts. Perform five abdominal thrusts. • Alternate between 5 blows and 5 abdominal thrusts. *If you're the only rescuer, perform back blows and abdominal thrusts before calling 9 -1 -1 or your local emergency number for help. 8 ** If another person is available, have that person call 9 -1 -1 while you perform first aid.

First Aid for Choking Abdominal Thrusts (Standing) 9 • Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly. • Make a fist with one hand. Position it slightly above the person's navel but below their ribs. • Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up. • Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.

First Aid for Choking Abdominal Thrusts (Lying Down) If the person is unconscious or too large to control standing, the American Heart Association recommends: 10 • Gently lay him or her flat on their back on the floor, face up. • Kneel and straddle the victim's thighs. • Place heel of one hand against the victim's abdomen, in the midline slightly above the navel and well below the tip of the breastbone/sternum. • Place other hand over the first hand. • Give one to five inward and upward thrusts (as needed). • Repeat procedure or begin use of the Dechoker*.

First Aid for Choking Abdominal Thrusts (Wheelchair) • Engage the wheelchair's brakes if not already on. • Stand or kneel behind the victim's wheelchair. • Proceed with normal abdominal thrust techniques. If the back of the wheelchair is too high: • Armrests can be removed, turn the person 90 degrees and proceed with normal abdominal thrust techniques. • Support person in a standing position and proceed with normal abdominal thrust techniques. • Transfer to the floor if person is too heavy and proceed with abdominal thrust techniques for someone lying down. * Again, this is where you may want to change to use of the Dechoker, especially if the person in need is not suitable for the abdominal thrusts procedures. 11

First Aid for Choking Anti-Choking Device (ACD) - Dechoker If rescue techniques for a choking victim are not successful, an Anti-Choking Device (ACD) may be used as the next intervention effort. The ACD we are talking about is the Dechoker. 12

Procedure and Protocol 1. Have someone call 911. Quickly remove the Dechoker from the package. Provide assurance that the Dechoker help is on the way. * Be prepared for the person to resist this process. Talk to them in a calming voice and assure them that what you are about to do will help them. 13

Procedure and Protocol 2. Tilt the head back and lift the chin for optimal access to the airway. 14

Procedure and Protocol 3. Insert the tube into the mouth with the respirator mask covering the mouth and nose. Use the tube to place over the tongue as a guide. 15

Procedure and Protocol 4. Hold the respirator mask between your thumb and fingers and apply light but firm pressure to form a seal between the face and mask. 16

Procedure and Protocol 5. Continue to apply light pressure on the respirator mask while pulling the plunger out with force to remove the obstruction. 17

Procedure and Protocol 6. If the obstruction is not dislodged, repeat steps 4 -5 and know that multiple pumps of the handle can be performed to create additional suction, if necessary. 18

Procedure and Protocol 7. Once the debris has been dislodged, roll the individual over on their side to allow additional debris and/or fluid out of the mouth. Continue to assist until emergency medical assistance arrives. 19

First Aid for Choking Anti-Choking Device (ACD) – Dechoker We hope with this reminder of what techniques should be used if someone is choking and how to use the Dechoker we are able to best protect those we support from a serious choking incident. This is a one time use item. If used, it needs to be disposed of and replaced with a new one. Know where this and other emergency equipment is kept in the sites you work in. 20

First Aid for Choking Anti-Choking Device (ACD) – Dechoker Should you have any questions or need more information about any of this, please talk with your training instructor, one of the health services staff or your supervisor. Remember, Prevention is the Best Practice! 21