First Responder EMS Curriculum for Training Centers in Eurasia

5. Repeat the sequence of tongue-jaw lift, finger sweep, attempt (and reattempt) toventilate, and Heimlich maneuver (steps 2 through 4) until the obstruction is clearedand the chest rises with ventilation or advanced procedures are available (i.e., Kellyclamp, Magill forceps, cricothyrotomy) to establish a patent airway.6. If the FBAO is removed and the airway is cleared, check breathing. If the victim isnot breathing, provide slow rescue breaths. Then check for signs of circulation (pulsecheck and evidence of breathing, coughing, or movement). If there are no signs ofcirculation, begin chest compressions.d. Victim found unresponsive1. Activate the emergency response system at the appropriate time in the CPRsequence. If a second rescuer is available, send that rescuer to activate the EMSsystem while you remain with the victim.2. Open the airway and attempt to provide rescue breaths. If you are unable to make thechest rise, reposition the victim's head (reopen the airway) and try to ventilate again.3. If the victim cannot be ventilated even after attempts to reposition the airway,straddle the victim's knees (see Figure 40) and perform the Heimlich maneuver (upto five times).4. After five abdominal thrusts, open the victim's airway using a tongue-jaw lift andperform a finger sweep to remove the object.5. Repeat the sequence of attempts (and reattempts) to ventilate, Heimlich maneuver,and tongue-jaw lift and finger sweep (steps 2 through 4) until the obstruction iscleared or advanced procedures are available to establish a patent airway (i.e., Kellyclamps, Magill forceps, or cricothyrotomy).6. If the FBAO is removed and the airway is cleared, check breathing. If the victim isnot breathing, provide two rescue breaths. Then check for signs of circulation (pulsecheck and evidence of breathing, coughing, or movement). If there are no signs ofcirculation, begin chest compressions.6. Techniques for Relief of Foreign Body Airway Obstruction in Infants andChildrena. Back blows and chest thrusts in the responsive infant1. Hold the infant prone with the head slightly lower than the chest, resting on yourforearm. Support the infant's head by firmly supporting the jaw. Take care to avoidcompressing the soft tissues of the infant's throat. Rest your forearm on your thigh tosupport the infant.2. Deliver up to five back blows forcefully in the middle of the back between theinfant's shoulder blades, using the heel of the hand. Each blow should be deliveredwith sufficient force to attempt to dislodge the foreign body.3. After delivering up to five back blows, place your free hand on the infant's back,supporting the occiput of the infant's head with the palm of your hand. The infantwill be effectively cradled between your two forearms, with the palm of one handsupporting the face and jaw, while the palm of the other hand supports the occiput.4. Turn the infant as a unit while carefully supporting the head and neck. Hold theinfant in the supine position, with your forearm resting on your thigh. Keep theinfant's head lower than the trunk.5. Provide up to five quick downward chest thrusts in the same location as chestcompressions, i.e., lower third of the sternum, approximately one finger's breadthbelow the intermammary line. Chest thrusts are delivered at a rate of approximatelyFirst Responder EMS Curriculum/AIHA, July 2002 271