Help! Choking! Nothing is working!

Possibility of using forceps or similar device for retrieval?

Thank you all for the very interesting thread.

I have a few questions regarding attempting to retrieve a lodged piece of meat in the throat while choking (conscious or unconscious).

When would you resort to using forceps or alike to attempt to grab the item and how often does this work? Usually, is this effective? What makes this not so effective?

Typically when choking, does the blockage hold the epiglottis closed or does the blockage get past the epiglottis and into the trachea?

Do EMT's have any tools to visualize a blocked airway? Can you look into a victims mouth or generally the back of the throat with a light or such?

What, if any tools do the emergency rooms have to retrieve items from blocked airways?

How often is Heimlich ineffective?

Thanks for reading... sorry for the vague questions.
 
Here's a Trick for y'all!

With a large chunk of something obstructing the airway, McGill forceps are an acceptable tool but forceps of any kind will be a port in a bad storm.

If after all the usual attempts fail (and your patient is getting bluer) position the patient, tilt the head back, open the mouth wide and then have someone press into the patient's abdomen.

The pressure often will make the obstruction (usually meat or something with "body" bulge out, allowing you to get a grip with the forceps or, if you have to, whatever.

In this case, anything you can do to promote visualization will help; what you are actually going for is traction.

I've used laryngoscope blades for the light, a partner for the pushing and forceps for the snag successfully a couple times.
 
more on blocked airways

firetender... Thank you for the helpful hints.

I am studying blockages in the airway and have yet to have a real case to learn from. My big question is, how often is a bolus of meat (or food) in an airway actually retrieveable.

Does the epiglottis ever preclude traction on the item?

How often can you see the blockage and is it usually holding the epiglottis closed or is it generally completely past the epiglottis and into the larynx (i.e. sitting on top of the vocal cords)?

Thanks.
 
emt4me said:
firetender... Thank you for the helpful hints.

I am studying blockages in the airway and have yet to have a real case to learn from. My big question is, how often is a bolus of meat (or food) in an airway actually retrieveable.

Does the epiglottis ever preclude traction on the item?

How often can you see the blockage and is it usually holding the epiglottis closed or is it generally completely past the epiglottis and into the larynx (i.e. sitting on top of the vocal cords)?

Thanks.
Click to expand...

The structure of the epiglotis is such that it is a moveable flap OVER the trachea that acts like a hinged garbage lid. Below it is the "hole" of the trachea which has two "ropes" stretching across it, kind of looking like this if you complete the circle, top and bottom.

( I I )

Most obstructions are minor and can be handled without visualization through Heimlich. The ones that are problematical are those where the "bolus" is big enough to be stuck between the vocal cords and press them out to the sides, completely filling the void.

If it's that big, it will usually have gained traction on the vocal cords, therefore have enough of its matter keeping the epiglotis OPEN.

You'll see an opened epiglotis "flap" open wide with NO vocal cords or tissue visible, only the obstruction.

In the unlikely possibility that the epiglotis is held "shut" then you need a laryngoscope to rise the flap and get under it to see what's up...er...what's down...um...what ain't quite in or out.
 
^
Since a picture is worth a thousand words, especially when it comes to anatomy...

Link directly to the fiberoptic bronchoscope.
http://www.youtube.com/watch?v=bDRTzmuwMnQ#t=2m19s

[youtube]http://www.youtube.com/watch?v=bDRTzmuwMnQ#t=2m19s[/youtube]
 
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LAS46 said:
I am sorry but if you blow the object into the lungs intentionally then you are at risk for a law suit... And that object being in the lungs can cause further injuries to the person... depending on what type of object it is, it may even puncture the lung or lungs or any number of things on the way down... I would recommend that you do not do as that instructor said. Follow the AHA protocol on what should be done while a person is choking.
Click to expand...


Is there further injuries then dead?

If I hear one more thing about avoiding a lawsuit.....My God. How do you do your job if everyone is so worried about being sued all the time?

Do whats best for your patient.
 
JPINFV said:
^
Since a picture is worth a thousand words, especially when it comes to anatomy...
Click to expand...

Good idea; there I was looking for some dirt to draw on! It was tough enough figuring which symbol most looked like vocal cords!
Was that related to television?

Oh, I hope you told him not to try this at home.
 
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