Wednesday, February 15, 2012

“Do not panic! Keep cool! This is not a joke!”

Disclaimer: The author did not receive any compensation or cash payment in writing this post; the author does not mean to persuade readers and has no intention to promote either. This is an honest opinion. 
Ivy became an explorer these past few days—putting everything into her mouths, became a rolling master, an hyperactive mover, a bouncing baby literally--which actually means she is now  prone to dangerous situations no matter how we try to make our environment a safe zone for her—I was overwhelmed by her as she learns new things one day at a time that I forgot the dangers of Ivy's stage.
The probability of dealing with airway obstruction  should not be disregarded especially at Ivy's age, aside from choking on solid foods, she might mistaken small objects a perfect toy! study shows many infants and children die of choking each year… Ivy wasn’t an exception of this crisis—she is a child, most of all a newbie who is eager to explore the world around her.
Sure is! 
Choking is indeed a scary—some say that it is not a life threatening but it felt like we’re in between-life-and-death situation last night! 
Where do I begin... 
I held Ivy to sleep before I laid her in crib, as usual…I then switched off the light and prepared myself for a bath when I suddenly heard her gagging and coughing hard so I hurriedly ran back to her. I knew something was wrong with her. I kept myself calm while as I hope she will be coughing out whatever is inside her mouth. High pitch sound while inhaling and gagging?!?! It only implies a partial blockage of airway.
Her breath smells like of the insect repellent we bought the other day which I rather stick on the pillow case than on her dress because of its strong odor. 

I checked her mouth and tried to swept her tongue with my finger..
I got nothing! 
I can't find the patch! 
The patch had probably get stucked in her throat... 
”she can’t be choking… 
She is not dying! 
I have to save her… 
what shall I do?!? 
God Help me!
Don't scare me, God... 
I have to do something... 
I knew it ain't the right time to call God and I know  a warm touch, a hug, a cuddle will never be a help.
 Emergency Medicine
I tried to recall what is taught, what i read, what is told, what I heard, what I once answered to a doctor during our practical exam back when I was a Med student
Argh! It is not even the right time to regret that I have not paid attention to lectures
I turned Ivy over on her tummy, with her head in my palm, trying to support her chest with my arms then I tried to tap her back with my other hand. Believe me! I felt how difficult it was in her part to struggle to grasp air. Very painful... I wanted to scream but I needed to stay calm. So I stayed calm.
I then thought of forcing her to vomit.
Gag reflex! 
I reached the back of her tongue with my finger, as far as I could. I sticked my finger down to her throat until she was able to throw up. I checked her mouth again  and I got a slimy mosquito patch. 
Ivy tried to swallow this Cow

Whew! Ivy then cried in fear
Ivy’s cry after I pulled out the patch from her mouth was a relief
 *tears of fear and tears of joy* 
she can finally breath normally... 
and in less than a minute, Ivy smile back to me as I told her "baby, Don't do that again please". 
It is my intention to guard her from mosquito bites that's why we bought the mosquito patch...still, I pleaded guilty for not taking into account the possible dangers it can cause us. Lesson learned? not to leave Ivy alone assuming she is safe in her bed as she sleeps and I have to be watchful with the items around us. 

Safety tips from Centers for Disease Control and Prevention:
These common household choke hazards should never be left within the reach of your child:

  • Coins
  • Marbles
  • Round watch batteries
  • Pen or marker caps
  • Small rubber toy car wheels
  • Foam balls that compress small enough to fit in your child's mouth
  • Buttons
  • Plastic bottle caps
At Mealtime
* Insist that your children eat at the table, or at least sitting down. Watch young children while they eat. Encourage them to eat slowly and chew their food well.
* Cut up foods that are firm and round and can get stuck in your child's airway, such as
  • hotdogs -always cut hotdogs length-wise and then into small pieces
  • grapes-cut them into quarters
  • raw vegetables-cut them into small strips or pieces that are not round
* Other foods that can pose a choking hazard include:
  • hard or sticky candy, like whole peppermints or caramels
  • nuts and seeds (don't give peanuts to children under age 7)
  • popcorn
  • spoonfuls of peanut butter
During Playtime
* Follow the age recommendations on toy packages. Any toy that is small enough to fit through a 11/4-inch circle or is smaller than 21/4 inches long is unsafe for children under 4 years old.
* Don't allow young children to play with toys designed for older children. Teach older children to put their toys away as soon as they finish playing so young siblings can't get them.
* Frequently check under furniture and between cushions for dangerous items young children could find, including:
  • coins
  • marbles
  • watch batteries (the ones that look like buttons)
  • pen or marker caps
  • cars with small rubber wheels that come off
  • small balls or foam balls that can be compressed to a size small enough to fit in a child's mouth
* Never let your child play with or chew on uninflated or broken latex balloons. Many young children have died from swallowing or inhaling them.
* Don't let your small child play on bean bag chairs made with small foam pellets. If the bag opens or rips, the child could inhale these tiny pieces.

And Here's What to do in case of emergency: (link to original source was provided)


Step 1: Assess the situation quickly.
If a baby is suddenly unable to cry or cough, something is probably blocking her airway, and you'll need to help her get it out. She may make odd noises or no sound at all while opening her mouth. Her skin may turn bright red or blue.

If she's coughing or gagging, it means her airway is only partially blocked. If that's the case, let her continue to cough. Coughing is the most effective way to dislodge a blockage.
On the other hand, if you suspect that the baby's airway is closed because her throat has swollen shut, call for an expert help immediately. She may be having an allergic reaction – to food or to an insect bite, for example – or she may have an illness, such as croup.
Step 2: Try to dislodge the object with back blows and chest thrusts. 
First do back blows
If a baby is conscious but can't cough, cry, or breathe and you believe something is trapped in his airway, carefully position him faceup on one forearm, cradling the back of his head with that hand.
Place the other hand and forearm on his front. He is now sandwiched between your forearms.
Use your thumb and fingers to hold his jaw and turn him over so that he's facedown along the other forearm. Lower your arm onto your thigh so that the baby's head is lower than his chest.
Using the heel of your hand, deliver five firm and distinct back blows between the baby's shoulder blades to try to dislodge the object. Maintain support of his head and neck by firmly holding his jaw between your thumb and forefinger.
Next, place your free hand (the one that had been delivering the back blows) on the back of the baby's head with your arm along his spine. Carefully turn him over while keeping your other hand and forearm on his front.

DO NOT perform these steps if the infant is coughing forcefully or has a strong cry – either of which can dislodge the object on its own.
Then do chest thrusts
Use your thumb and fingers to hold his jaw while sandwiching him between your forearms to support his head and neck. Lower your arm that is supporting his back onto your opposite thigh, still keeping the baby's head lower than the rest of his body.
Place the pads of two or three fingers in the center of the baby's chest, just below an imaginary line running between his nipples. To do a chest thrust, push straight down on the chest about 1 1/2 inches. Then allow the chest to come back to its normal position.
Do five chest thrusts. Keep your fingers in contact with the baby's breastbone. The chest thrusts should be smooth, not jerky.
Repeat back blows and chest thrusts
Continue alternating five back blows and five chest thrusts until the object is forced out or the baby starts to cough forcefully, cry, or breathe on his own. If he's coughing, let him try to cough up the object.
If the baby becomes unconscious
If a baby who is choking on something becomes unconscious, you'll need to do what's called modified CPR. Here's how to do modified CPR on a baby:
Open his mouth and look for an object. If you can see an object, remove it with your little finger.
Give him two rescue breaths. If the air doesn't go in (you don't see his chest rise), tilt his head and try two rescue breaths again.

If his chest still doesn't rise, do 30 chest compressions.
Look in his mouth and remove the object if you see it. Give him two more rescue breaths.
Repeat the chest compressions and so on, until help arrives.

 perform CPR
CPR stands for cardiopulmonary resuscitation. This is the lifesaving measure you can take to save a baby who shows no signs of life (consciousness or effective breathing).
CPR uses chest compressions and "rescue" breaths to make oxygen-rich blood circulate through the brain and other vital organs until emergency medical personnel arrive. Keeping oxygenated blood circulating helps prevent brain damage – which can occur within a few minutes – and death.
CPR isn't hard to do. Follow these steps:
Step 1: Check the baby's condition.
Is the baby conscious? Flick her foot or gently tap on her shoulder and call out. If she doesn't respond, have someone call 911 or the local emergency number. (If you're alone with the baby, give two minutes of care as described below, then call 911 yourself.)
Swiftly but gently place the baby on her back on a firm, flat surface.
Make sure she isn't bleeding severely. If she is, take measures to stop the bleeding by applying pressure to the area. Don't administer CPR until the bleeding is under control.
Step 2: Open the baby's airway.
Tilt the baby's head back with one hand and lift his chin slightly with the other. (You don't have to tilt a baby's head back very far to open the airway.)
Check for signs of breathing for no more than ten seconds.
To check for breathing in a baby, put your head down next to his mouth, looking toward his feet. Look to see whether his chest is rising, and listen for breathing sounds. If he's breathing, you should be able to feel his breath on your cheek.
Step 3: Give two gentle "rescue" breaths.
If the baby isn't breathing, give her two little breaths, each lasting just one second. Cover the baby's nose and mouth with your mouth and gently exhale into her lungs only until you see her chest rise, pausing between rescue breaths to let the air flow back out.
Remember that a baby's lungs are much smaller than yours, so it takes much less than a full breath to fill them. Breathing too hard or too fast can force air into the baby's stomach.
If her chest doesn't rise, her airway is blocked. Give her first aid for choking, described above.
Step 4: Do 30 chest compressions.

With the baby still lying on his back, place the pads of two or three fingers in the center of his chest, just below an imaginary line running between his nipples.
With the pads of your fingers on that spot, compress the chest about 1 1/2 inches. Push straight down. Compressions should be smooth, not jerky.
Do 30 chest compressions at the rate of 100 per minute. When you complete 30 compressions, give two rescue breaths (step 3, above). (Each cycle of chest compressions and rescue breaths should take about 24 seconds.)
Step 5: Repeat compressions and breaths.

Repeat the sequence of 30 compressions and two breaths. If you're alone with the baby, call 911 or the local emergency number after two minutes of care.
Continue the sequence of compressions and breaths until help arrives, you find an obvious sign of life, an AED (automated external defibrillator) is ready to use, the scene becomes unsafe, or you are too exhausted to continue.
Even if the baby seems fine by the time help arrives, a doctor will need to check her to make sure that her airway is completely clear and she hasn't sustained any internal injuries.
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