Step 8. Turn the infant to face-down position.
• Continue to stress head and neck support. Step 9. Repeat steps 5, 6, 7 and 8.
• Infant’s head should be lower than its chest at all times. • With back blows, the infant’s head must be lower than the chest so that once the object is loosened, it falls toward the mouth and doesn’t move deeper into the airway. With chest thrusts, keeping the head down makes it possible for gravity to help the “substitute cough” move the object toward the mouth. During turns, the head must be lower than the chest to prevent a loosened object from falling deeper into the airway.
Step 10. Don’t give up. Continue doing back blows and chest thrusts supporting the head and neck during turns until the object is “coughed out” and the infant can breathe, cough, or cry or until the infant stops responding or loses consciousness.
• Do not give up if initial attempts to relieve blocked airway aren’t successful. As infant becomes weaker, muscles relax, and back blows/ chest thrusts may become more effective.
Step 11. If the infant loses consciousness, and you haven’t yet called 9-1-1, take infant with you and call 9-1-1 for further instructions.
• 9-1-1 will talk you through what to do. You will need to begin CPR immediately.
Step 12. If the infant begins to breathe, cough, or cry, stop giving back blows and chest thrusts.
Remember to always call the infant’s parent after 9-1-1 arrives or if you have given back blows and chest thrusts. The infant should be seen by a physician.
ROLE-PLAY: PARTICIPANTS PRACTICE ON INFANT MANIKIN
• Participants should be in groups of no more than 8.
• Participants should be seated on the edge of a chair with their legs out in front of them, forming a ramp.
• Read at least one scenario to the participants. Go through as many scenarios as you have time for. As participants practice, call out each step of choking infant rescue (steps 1-12 listed above).
• Participants should watch the infant and should not begin back blows/ chest thrusts until after the Instructor announces effective coughing has stopped.
• Make sure that each scenario has a successful outcome. After each scenario is complete, ask the participants:
– When do you start and stop back blows/chest thrusts? – How could you have prevented this?
GRANDPARENTS: GETTING STARTED INSTRUCTOR MANUAL | PAGE 27
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