• Correct positioning of hands and arms will prevent damage to soft organs under the ribs.
• Abdominal thrusts are inward and upward, like scooping ice cream.
• The directions say to give up to 5 abdominal thrusts because if the object comes out before 5 abdominal thrusts, you stop.
Step 6. After every 5 abdominal thrusts: Check your hands to be sure they are in the correct position-slightly above the belly button and well below the lower tip of the breastbone. Check your arms to be sure they are in the correct position under the child’s arms and below the child’s ribs. Check the condition of the child.
• As child becomes limp due to lack of oxygen, child may slip down causing rescuer’s arms to be in wrong position over the ribs. If that happens, your abdominal thrusts may not work and you could injure the child.
Step 7. Don’t give up. Continue giving abdominal thrusts until the object is “coughed out” and the child can breathe, cough, or talk, or until the child stops responding or loses consciousness.
• Do not give up if initial attempts to relieve blocked airway aren’t successful. As child becomes weaker, muscles relax and abdominal thrusts may become more effective.
Step 8. If the child loses consciousness, lower the child to the ground face-up and call 9-1-1 for further instructions.
• 9-1-1 will talk you through what to do.
Step 9. If the child begins to breathe, cough, or talk, stop giving abdominal thrusts.
Step 10. Always call the child’s parent after 9-1-1 arrives or if you have given abdominal thrusts.
• Child should be seen by physician. • Tell child’s parent if abdominal thrusts made the child better and the object came out or if the child got better with abdominal thrusts but you did not see the object come out.
Note to Instructor: The case of the disappearing obstruction
If the object goes down further into one of the two major bronchi or if the child gets better but nothing is coughed up, the child will appear to have improved because although one bronchus is blocked, the other bronchus is open and oxygen can get to one lung. However, the lung with the blocked bronchus will either collapse and/or get infected. The child will need to have the object removed surgically at some point although the problem may not be diagnosed for several days or weeks. Emphasize to students that it is very important that they tell the child’s parent because the child will need to be seen by a physician.
PAGE 38 | SAFE SITTER® INSTRUCTOR MANUAL UPDATED 2023
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