Performance Guidelines

Relief of Obstructed Airway: Infant Becomes Unconscious

Objectives Critical Performance Reason

Assessment:
Loss of consciousness in infant with complete airway obstruction. Shout for help.

Action:
Perform tongue-jaw lift. Remove obstructing object if you see it.

Call out "Help!" If someone comes, that person should activate the EMS system. Position infant on back.

Open the mouth using tongue-jaw lift by placing your thumb in the infant's mouth over the tongue. Lift the tongue and jaw outward. If you see a foreign body, remove it. Do not perform a blind finger sweep.

This initial call will alert bystanders and may enable them to activate the EMS system while you try to relieve the obstruction.

Remove the object if you see it. Blind finger sweeps should not be performed because they may push the obstructing object back into or further into the
airway.

Action:
Attempt to give 2 rescue breaths. If unsuccessful, reposition the head and try again. Open airway with head tilt–chin lift and try to give breaths. If the chest does not rise, reposition the head and try again to give rescue breaths. You must ensure that the head is properly positioned before you decide that the airway is obstructed by a foreign body.

Action:
Deliver up to 5 back blows. Deliver back blows with infant positioned face down (as before).

Action:
Deliver up to 5 chest thrusts over the lower half of the sternum (avoid the xiphoid). Find finger position as for chest compressions and deliver up to 5 compressions.

Action:
Perform tongue-jaw lift. Remove object if seen. If you see the object, remove it. Do not perform blind finger sweeps. Blind finger sweeps may push the object back into or further into the airway.

Action:
After each series of 5 back blows and 5 chest thrusts, perform tongue-jaw lift and remove object if seen. Open the airway and try to give rescue breaths. If unsuccessful, reposition head and reattempt breaths. Repeat these steps until rescue breaths are given successfully. If you are alone, activate the EMS system after about 1 minute of efforts to clear the airway. Some airway obstruction may be caused by incorrect head and neck position.

Action:
Activate the EMS system after approximately 1 minute. Activation of the EMS system will ensure the arrival of trained personnel.

Action:
When obstruction is removed, check for breathing and pulse.
Open the airway and check for breathing.

If there is no breathing, give 2 breaths. Check for a pulse.

If a pulse is present, provide 20 breaths per minute and continue to monitor pulse.
If there is no pulse, begin cycles of compressions and breaths.

If breathing resumes and there is no evidence of trauma, place the infant on one side in the recovery position and await the arrival of emergency personnel.

Objectives	Critical Performance	Reason
Assessment: Loss of consciousness in infant with complete airway obstruction. Shout for help. Action: Perform tongue-jaw lift. Remove obstructing object if you see it.	Call out "Help!" If someone comes, that person should activate the EMS system. Position infant on back. Open the mouth using tongue-jaw lift by placing your thumb in the infant's mouth over the tongue. Lift the tongue and jaw outward. If you see a foreign body, remove it. Do not perform a blind finger sweep.	This initial call will alert bystanders and may enable them to activate the EMS system while you try to relieve the obstruction. Remove the object if you see it. Blind finger sweeps should not be performed because they may push the obstructing object back into or further into the airway.
Action: Attempt to give 2 rescue breaths. If unsuccessful, reposition the head and try again.	Open airway with head tilt–chin lift and try to give breaths. If the chest does not rise, reposition the head and try again to give rescue breaths.	You must ensure that the head is properly positioned before you decide that the airway is obstructed by a foreign body.
Action: Deliver up to 5 back blows.	Deliver back blows with infant positioned face down (as before).
Action: Deliver up to 5 chest thrusts over the lower half of the sternum (avoid the xiphoid).	Find finger position as for chest compressions and deliver up to 5 compressions.
Action: Perform tongue-jaw lift. Remove object if seen.	If you see the object, remove it. Do not perform blind finger sweeps.	Blind finger sweeps may push the object back into or further into the airway.
Action: After each series of 5 back blows and 5 chest thrusts, perform tongue-jaw lift and remove object if seen. Open the airway and try to give rescue breaths. If unsuccessful, reposition head and reattempt breaths.	Repeat these steps until rescue breaths are given successfully. If you are alone, activate the EMS system after about 1 minute of efforts to clear the airway.	Some airway obstruction may be caused by incorrect head and neck position.
Action: Activate the EMS system after approximately 1 minute.		Activation of the EMS system will ensure the arrival of trained personnel.
Action: When obstruction is removed, check for breathing and pulse.	Open the airway and check for breathing. If there is no breathing, give 2 breaths. Check for a pulse. If a pulse is present, provide 20 breaths per minute and continue to monitor pulse. If there is no pulse, begin cycles of compressions and breaths. If breathing resumes and there is no evidence of trauma, place the infant on one side in the recovery position and await the arrival of emergency personnel.