First Responder EMS Curriculum for Training Centers in Eurasia

Two types of conventional forceps are acceptable for removal of a foreign body, the Kelly clampand the Magill forceps. Forceps should be used only if the foreign body is seen. Either alaryngoscope or tongue blade and flashlight can be used to permit direct visualization. The use ofsuch devices by untrained or inexperienced persons is unacceptable. Cricothyrotomy should beperformed only by healthcare providers trained and authorized to perform this surgicalprocedure.Healthcare Provider Relief of FBAO in Victims Found UnresponsiveIf the victim is found to be unresponsive and the cause is unknown, the following sequence ofactions is recommended:1. Activate the emergency response system at the appropriate time in the CPR sequence. If asecond rescuer is available, send that rescuer to activate the EMS system while you remainwith the victim.2. Open the airway and attempt to provide rescue breaths. If you are unable to make the chestrise, 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 thevictim's knees (see Figure 40) and perform the Heimlich maneuver (up to 5 times).4. After 5 abdominal thrusts, open the victim's airway using a tongue-jaw lift and perform afinger sweep to remove the object.5. Repeat the sequence of attempts (and reattempts) to ventilate, Heimlich maneuver, andtongue-jaw lift and finger sweep (steps 2 through 4) until the obstruction is cleared oradvanced procedures are available to establish a patent airway (i.e., Kelly clamps, Magillforceps, or cricothyrotomy).6. If the FBAO is removed and the airway is cleared, check breathing. If the victim is notbreathing, provide 2 rescue breaths. Then check for signs of circulation (pulse check andevidence of breathing, coughing, or movement). If there are no signs of circulation, beginchest compressions.First Responder EMS Curriculum/AIHA, July 2002 377