Before we practice, let’s find the correct location for abdominal thrusts and make a fist.
• Have all students locate on themselves the lower end of the sternum by pressing along the breastbone and then moving down toward the abdomen and above the belly button.
• Instructor demonstrates making a fist with thumb outside, and puts thumb side of fist slightly above belly button with base knuckles (large knuckles where fingers join hand) facing up towards head.
• Have all students practice making a fist. Instructor should check hand position for correctness.
Now I’m going to go through the steps on how to rescue a child who is choking. Follow along with me using your own manikin. [Read each step below as participants practice on t heir manikins. Emphasize the bulleted points as you discuss.]
Note to Instructor: To avoid injury, students should NOT practice abdominal thrusts on each other.
Step 1. Encourage the child to cough. Ask an older child, “Are you choking?” Do not pat or slap the child on the back.
• Coughing is not choking. Coughing is the body’s defense against airway trespassers like solids or liquids. Choking occurs when coughing fails to remove the blockage and air cannot move past the blockage into or out of the lungs. The body cannot get rid of the blockage without help.
• Choking is a THREAT TO LIFE that requires immediate action.
• Patting or slapping on the back while child is upright may cause the object to go further down into the airway.
Step 2. Prepare to give abdominal thrusts if the child nods yes, is unable to cough or talk, or if cough becomes very weak. Tell the child you are going to help.
• Child may clutch throat to indicate choking. • Choking is scary for the child and the sitter.
Step 3. Ask anyone who can to call 9-1-1 for help. If you are alone, do not delay rescue attempts to make the call.
• A sibling who is present may be able to call 9-1-1.
Step 4. Get in position to give abdominal thrusts. Kneel or stand behind the child and put your arms around the child’s body making sure your arms are under child’s arms and below child’s ribs.
• Kneel or stand behind child so abdominal thrusts will be effective. Putting child on your lap won’t work.
Step 5. Give up to 5 abdominal thrusts. Make a fist with one hand. Place thumb of your fist slightly above the child’s belly button and well below the lower tip of breastbone. Grasp your fist with your other hand and “cough” for the child by giving up to 5 quick, forceful, upward abdominal thrusts. Say out loud, “Cough! Cough! Cough! Cough! Cough!”
UPDATED 2023 SAFE SITTER® INSTRUCTOR MANUAL | PAGE 37
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