If you talk and laugh while eating and food gets stuck in your trachea, what should you do to provide first aid?

Author: Jia Dacheng, first aid expert at Beijing Emergency Center

Reviewer: Wang Lixiang, Chief Physician, Third Medical Center, PLA General Hospital

We often say "Don't talk while eating and don't talk while sleeping".

“Don’t talk when sleeping” is because talking loudly before going to bed will make the brain too excited, and after lying down, you will not be able to calm down and will not be able to fall asleep for a long time.

Then there is some truth in the saying “don’t talk while eating”, because talking while eating will not only affect digestion, but also easily cause choking and coughing. If food gets into the trachea, which is medically known as “foreign body in the airway”, it may lead to very serious consequences.

1. Who is prone to airway foreign body problems?

There are two types of people who are most likely to have foreign bodies in the airway: infants and young children, especially children under three years old, and the elderly.

Figure 1 Original copyright image, no permission to reprint

Infants and young children have incomplete swallowing functions and their teeth have not fully grown. In addition, children are prone to playing with glass balls and coins, which can easily enter their airways if they are not careful.

For the elderly, due to tooth loss and deterioration of swallowing function, especially patients with cerebrovascular disease, their swallowing function is affected. These are the reasons why their incidence of airway foreign bodies is higher than other groups.

Of course, young people may also have foreign bodies in their airways, such as drinking too much, falling into a coma, eating too quickly, or talking and laughing while eating, etc. Sometimes they may just throw a peanut and catch it with their mouths for fun. If they happen to inhale at that time, it is very likely to enter the airway and cause airway obstruction.

Once the airway is obstructed, it will lead to emergency situations such as severe coughing, difficulty breathing, and even suffocation. Immediate rescue is required to remove the foreign body as soon as possible and keep the airway open, otherwise serious consequences will occur.

2. How to provide first aid when an adult has a foreign body in the airway?

In the 1970s, there was a surgeon in the United States named Heimlich. Professor Heimlich found that many people died due to foreign objects in the airway. Shocked, he created a method of manually removing foreign objects from the airway, and this method gradually gained everyone's recognition.

Professor Heimlich is also considered the person who has saved the most lives in the world. Former US presidents Carter, Reagan, Bush, and the famous actress Elizabeth have all been successfully rescued using this method.

The specific method is:

When an adult has a foreign body in the airway, the upper abdominal impact method in the Hay method can be used. The rescuer stands behind the person being rescued, makes a fist with the left thumb inside, and places it two horizontal fingers above the navel of the person being rescued. The right hand covers the left hand to hug the person being rescued, and then inserts one leg between the legs of the person being rescued, bends the front leg, and pushes the back leg, and continuously and quickly impacts backward and upward until the foreign body comes out or the patient loses consciousness.

Figure 2 Original copyright image, no permission to reprint

After the patient loses consciousness, the rescuer lays the patient flat and continues to rescue him.

After laying the patient flat, the rescuer immediately performs cardiopulmonary resuscitation on the patient. He kneels on one side of the patient, places the base of his palm on the midpoint of the line connecting the patient's two nipples, and presses vertically downward with a depth of at least 5 cm and a frequency of 100 to 120 times per minute until the foreign body comes out.

There is also a special situation where the patient is extremely obese or a pregnant woman. The effect of upper abdominal impact on obese patients is poor, and abdominal impact on pregnant women is more dangerous, so chest impact is needed.

Where should you hit specifically? The midpoint of the line connecting the two nipples is the center of the sternum. Make a fist and continuously hit backwards with force until the foreign body is knocked out.

After the patient loses consciousness, the rescuer also needs to lay the patient flat and continue cardiopulmonary resuscitation. After laying the patient flat, the rescuer kneels on one side of the patient's body and continuously impacts the chest, checking every five times to see if the foreign body has come out. If the foreign body has come out, tilt the patient's head to one side and pick out the foreign body.

3. How to provide first aid when a child has a foreign body in his airway?

The incidence of airway foreign bodies in children is much higher than that in adults. What should we do when encountering this situation?

If there is a foreign object in the airway of a baby under one year old, immediately use one hand to hold his head and neck, turn him over and let him lie on your forearm, with his legs straddling your arm, and then use the base of your palm to tap the baby's interscapular area, which is between the two shoulder blades. After tapping five times in a row, turn him over to face up and check if there is any foreign object in his mouth.

If not, use this hand to fix the head, and immediately use the index finger and middle finger together to hit the bottom of the midpoint of the line connecting the two nipples of the baby. Do this five times in a row to see if the foreign body comes out. If not, fix the baby face down again and tap the back five times.

Figure 3 Original copyright image, no permission to reprint

Whether you are tapping the back or striking the chest, you must pay attention to one principle: the head must be low and the feet must be high. This not only utilizes the vibration, but also utilizes the gravity, so that the foreign body can be removed. In addition, the success rate will be higher if the two methods are used alternately.

If the foreign object is in the airway of a child over one year old, the rescuer can sit or kneel on one knee and let the child lie on one of the rescuer's legs, head down, buttocks up, and tap the back.

For older children, around five or six years old, or seven or eight years old, you can also use adult first aid methods, wrap your arms around the child, and use your hands to impact the child's upper abdomen or chest.

Once a foreign body occurs in the airway, it is extremely urgent, and its danger level is even second only to cardiac arrest. While performing rescue operations, you should immediately call 120, or have two people drive the patient to the hospital, with one person driving and the other person also performing rescue operations continuously on the way.