How to react when a child is choking?

Little Lilian died aged two years and 11 months after choking on a Herta brand Knacki sausage. After the food group was released at first instance, in January 2021 at the Dax Criminal Court, the court ordered an expert report to measure the “spongy and sticky” nature of the Knacki or their “swelling in contact with children’s saliva”. For their part, the parents of the child are still pleading for better information on the packages, so that this tragedy is not repeated.

What to do in case of choking?

First cause of cardiorespiratory arrest in children under 8 years old, suffocation must be quickly taken care of to unclog the airways. The support techniques differ slightly when it comes to an adult or a child.

Two scenarios

When a person chokes, there are two scenarios, according to Dr. Kierzek.

• “Either she talks and coughs, air can circulate. In this case it is preferable to do nothing because there is no vital emergency. On the contrary, making an inopportune gesture could displace the foreign body which partially blocks the trachea and this risks obstructing it completely” first indicates the emergency physician. “Once recovered, the person may possibly consult and undergo a fibroscopy to remove the element that choked him, if he did not spit it out“.
• In the second case, the person who is choking does not emit any sound, he cannot speak or breathe, he turns blue. “There, you have to react quickly, by putting big slaps between the shoulder blades, five in number, while the person leans forward”. If this technique is not enough to spill the beans, after five slaps, you have to go to the Heimlich maneuver, to make a piston.

“The maneuver consists of surrounding the person who is choking with his arms by putting himself behind his back, joining his hands at the level of his stomach and pressing strongly towards himself and upwards to create an overpressure at the level of the diaphragm and allow the person to expel the stuck foreign body” adds Dr. Kierzek.

“At the same time, you have to warn the emergency services and not stop these two techniques by alternating them until the person spits it out.”.

What are the differences in children?

In children, the two cases must be distinguished in the same way. If the child is over two years old, proceed as for adults.

On the other hand, if the child is less than two years old, it must be picked up, seated and laid on its stomach along its own leg, with its face exposed. Thus positioned, slightly sloping, it is necessary to give him slaps in the back in order to unclog the trachea. “After five slaps between his shoulder blades, if that doesn’t work, you have to turn the child over on his back and press at his stomach this time, it’s the Mofenson maneuver in children under two.” exposes Dr. Kierzek again.

On the other hand, the emergency doctor advises against taking a child by the feet to shake him upside down. Finally, whatever the outcome of the intervention, in particular if the person recovers after spitting up what suffocated him, medical advice must be taken in all cases.

Focus on prevention

In children in particular, prevention is essential. Indeed, their trachea is about the diameter of a finger, so anything larger can obstruct it. “It is therefore necessary to think of cutting food into small pieces, but also to eat in peace, without speaking or agitating and beyond food, it is necessary to pay attention to small objects and toys in particular that young children like to put in the mouth” adds the doctor again.

Beware of penetration syndrome!

Finally, there is a special case that may go unnoticed in children: the penetration syndrome. “In this case, the child chokes, he coughs and later gets better. The problem is that the foreign body has passed through the trachea, so it will stay in place and risk becoming infected. The child must be quickly seen in consultation for a chest X-ray and removal of the object by fibroscopy” says Gérald Kierzek.