# Choking signal to save lives...



## billc (Nov 5, 2012)

I didn't know exactly where to post this.  My sister-in-law has a friend who recently lost her husband because of a choking incident.  They were at a party and he ate something and started choking.  Eight people tried to do dislodge the food, but they all failed and he died.  A guy I work with was out to dinner with his wife and she ate something and started choking.  He initiated the Heimlick and the first attempt failed.  He then bent her forward at the waist and he said he pulled up so hard that he thought he broke her ribs, and finally dislodged the food.

My brothers mother in law also had a choking incident and this brought up this thread.  I think someone needs to come up with a hand signal that people can use to let others know they are choking.  This may sound silly, but seconds can be important and when a choking incident starts, people around the victim may not realize what the victim is trying to convey.   My brothers mother in law kind of waved her hands in front of her throat, and even then, her husband didn't understand what was happening.  My brother, when he saw what was going on shouted that she was choking, and they managed to save her.

I was thinking that some universal hand gesture that would immediately alert everyone that someone is choking might help cut down on the confusion, and get people helping the victim more quickly.  Any thoughts?


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## Steve (Nov 5, 2012)

billcihak said:


> I didn't know exactly where to post this.  My sister-in-law has a friend who recently lost her husband because of a choking incident.  They were at a party and he ate something and started choking.  Eight people tried to do dislodge the food, but they all failed and he died.  A guy I work with was out to dinner with his wife and she ate something and started choking.  He initiated the Heimlick and the first attempt failed.  He then bent her forward at the waist and he said he pulled up so hard that he thought he broke her ribs, and finally dislodged the food.
> 
> My brothers mother in law also had a choking incident and this brought up this thread.  I think someone needs to come up with a hand signal that people can use to let others know they are choking.  This may sound silly, but seconds can be important and when a choking incident starts, people around the victim may not realize what the victim is trying to convey.
> 
> I was thinking that some universal hand gesture that would immediately alert everyone that someone is choking might help cut down on the confusion, and get people helping the victim more quickly.  Any thoughts?


I thought that the sign was to put both hands to your throat. 

Like this:

View attachment $choking.jpg

We have some medical folks here.  Am I wrong?


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## Dirty Dog (Nov 5, 2012)

You are correct, Steve. 
Unfortunately, there's no such thing as a universal hand gesture for anything. Especially when the person choking panics and their brain disconnects. The sign you posted was chosen because it is, while not universal, something that people tend to do when they're choking, thinking or not.
Bill, if you've taken a CPR course, you should have already been aware of this signal. That you are not, simply points up a major problem. People don't take advantage of the opportunities to take such classes, with tragic outcomes.


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## Master Dan (Nov 5, 2012)

My wife is an RN with a speacial for ER and Critical Care and has said that bending the person over and striking the back properly is better


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## jks9199 (Nov 5, 2012)

Master Dan said:


> My wife is an RN with a speacial for ER and Critical Care and has said that bending the person over and striking the back properly is better


In my experience, striking the back is generally discouraged with adults because it can actually lodge the foreign matter more firmly and deeply.  That's from the American Heart Association and Red Cross CPR and first responder courses...


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## Dirty Dog (Nov 5, 2012)

Master Dan said:


> My wife is an RN with a speacial for ER and Critical Care and has said that bending the person over and striking the back properly is better



You wife might wish to update her training. This is NOT current practice, as it can cause the object to become more firmly lodged in the trachea. A properly applied heimlich maneuver is the best thing the lay person can do. Hell, it's what *I* would do, too. At least initially.

Bear in mind that if the person choking is able to breath, you should do nothing, as difficult as that can be. Let them cough, if they're able.


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## Cyriacus (Nov 6, 2012)

I think the problem is more that alot of people have no idea what to do if someones choking?


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## Dirty Dog (Nov 6, 2012)

Cyriacus said:


> I think the problem is more that alot of people have no idea what to do if someones choking?



That is indeed the problem. If people took advantage of the readily available, cheap (often free) courses available, they'd not only know how to recognise someone who is choking, but also what to do (and not do) about it.


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## Cyriacus (Nov 6, 2012)

Dirty Dog said:


> That is indeed the problem. If people took advantage of the readily available, cheap (often free) courses available, they'd not only know how to recognise someone who is choking, but also what to do (and not do) about it.


And this is why i think first aid should be a thing in schools.


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## Bill Mattocks (Nov 6, 2012)

A properly-applied Heimlich will save a life.  It will also break bones, and often the person comes uncorked on both ends, so to speak.  Better than the alternative, IMHO.  And I agree with DD.  If they are coughing, they are breathing.  If they are gasping, they are breathing.  If they are NOT coughing and gasping, then they could be choking.

http://www.ou.edu/oupd/choke.htm


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## Bill Mattocks (Nov 6, 2012)

Cyriacus said:


> And this is why i think first aid should be a thing in schools.



Isn't it?  We had it in junior high and high school.  Hands-on training and certification was available, and we had school assemblies where we were just shown various life-saving methods.  That was a long time ago, though.

The only thing I've ever objected to is that the methods kept changing and the names kept changing as well.  CPR became "Rescue Breathing" became I can't remember what, and it was X compressions, Y breaths, and then more compressions, fewer breaths, then just breathing and no chest compressions, and OMG people, make up your freaking minds.


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## Dirty Dog (Nov 6, 2012)

Cyriacus said:


> And this is why i think first aid should be a thing in schools.



That would be a START, but things change. We learn, and recommendations keep pace.
For example, I think it's only a matter of time before bystander CPR no longer includes rescue breathing of any sort, for good reasons.
People need to not only take the classes, they need to retake them. That's why the cards expire...


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## Dirty Dog (Nov 6, 2012)

Bill Mattocks said:


> Isn't it? We had it in junior high and high school. Hands-on training and certification was available, and we had school assemblies where we were just shown various life-saving methods. That was a long time ago, though.
> 
> The only thing I've ever objected to is that the methods kept changing and the names kept changing as well. CPR became "Rescue Breathing" became I can't remember what, and it was X compressions, Y breaths, and then more compressions, fewer breaths, then just breathing and no chest compressions, and OMG people, make up your freaking minds.



Things will continue to change until our understanding of human pathophysiology is 100% perfect. That ain't going to happen anytime soon.


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## jks9199 (Nov 6, 2012)

Dirty Dog said:


> That is indeed the problem. If people took advantage of the readily available, cheap (often free) courses available, they'd not only know how to recognise someone who is choking, but also what to do (and not do) about it.


It's not necessarily that they don't know what to do.  It's a big step for a lot of people to intervene in any situation, even to the small extent of dialing 911 -- let alone actually grabbing someone and doing something direct like the Heimlich that requires them to actually touch or lay hands on the victim.


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## jks9199 (Nov 6, 2012)

Bill Mattocks said:


> The only thing I've ever objected to is that the methods kept changing and the names kept changing as well.  CPR became "Rescue Breathing" became I can't remember what, and it was X compressions, Y breaths, and then more compressions, fewer breaths, then just breathing and no chest compressions, and OMG people, make up your freaking minds.


CPR or Cardio Pulmonary Resuscitation has, to my knowledge, always been "CPR."  Rescue breathing used to be called artificial respiration; I suspect the name was changed to make it sound less intimidating.

As to the methods -- Over the last 10 years, they've only gotten simpler, based on determining what's more effective.  Now, for most people, they don't even worry about combining chest compressions with breaths; it's just pump the heart.  Use rescue breathing in cases where they aren't breathing -- but do still have a pulse. But a small note on effectiveness is appropriate:  in the field, CPR doesn't have a huge success rate.  Absolutely still worth trying -- but the fact is that someone whose heart has stopped is generally pretty sick at that point.


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## Tez3 (Nov 6, 2012)

Dirty Dog said:


> That would be a START, but things change. We learn, and recommendations keep pace.
> For example, I think it's only a matter of time before *bystander CPR no longer includes rescue breathing of any sort,* for good reasons.
> People need to not only take the classes, they need to retake them. That's why the cards expire...



Already does here.


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## Cyriacus (Nov 6, 2012)

Bill Mattocks said:


> Isn't it?  We had it in junior high and high school.  Hands-on training and certification was available, and we had school assemblies where we were just shown various life-saving methods.  That was a long time ago, though.
> 
> The only thing I've ever objected to is that the methods kept changing and the names kept changing as well.  CPR became "Rescue Breathing" became I can't remember what, and it was X compressions, Y breaths, and then more compressions, fewer breaths, then just breathing and no chest compressions, and OMG people, make up your freaking minds.



Not in Australia, apparently. Good on them for doing anything.


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## K-man (Nov 6, 2012)

Dirty Dog said:


> That would be a START, but things change. We learn, and recommendations keep pace.
> For example, I think it's only a matter of time before bystander CPR no longer includes rescue breathing of any sort, for good reasons.
> People need to not only take the classes, they need to retake them. That's why the cards expire...


That has already happened with first aid training here.  Although the two breaths and thirty compressions is the recommendation, it is now acceptable to leave out the breaths as there is no evidence to show the outcome to be different.


As to the Heimlich manoeuvre, it is now out too.



> *Adult/Child (over 1 year)*
> 1 Encourage adult or child to relax, breathe deeply and cough to remove object.
> 
> 
> ...


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## Carol (Nov 6, 2012)

Cyriacus said:


> And this is why i think first aid should be a thing in schools.



In many cases it is, and actually in the OP's state of Illinois, First Aid as well as CPR is mandatory a requirement for high school graduation...or at least it used to be.

Training does change tho...and it can be forgotten.  For a few of us, high school was quite awhile ago.

I think it would be more helpful to ask about it at work.  Last week someone asked if there was an AED in our building (there isn't).  That set off a conversation that led to a flurry of activity, including folks (including a part-time consultant!) that weree willing to chip in for a part-time AED for the office and an engineer/part-time firefighter that is looking for a way for all of us to get recertified in CPR.


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## Dirty Dog (Nov 6, 2012)

jks9199 said:


> It's not necessarily that they don't know what to do.  It's a big step for a lot of people to intervene in any situation, even to the small extent of dialing 911 -- let alone actually grabbing someone and doing something direct like the Heimlich that requires them to actually touch or lay hands on the victim.



While what you say is true, we've seen plenty of examples in this thread of people who did not know what to do. Including a professional, who really really really ought to know exactly what to do.


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## Dirty Dog (Nov 6, 2012)

K-man said:


> That has already happened with first aid training here.  Although the two breaths and thirty compressions is the recommendation, it is now acceptable to leave out the breaths as there is no evidence to show the outcome to be different.



Outcomes are actually marginally better if you don't bother with the rescue breathing.
Rescue breathing causes insufflation of the stomache, which in turn  increases the risks of vomiting and aspiration. Given that the cardiac output during CPR is only about 25% of what it would be normally, there is sufficient air moved with compressions. At least until such time as someone is able to provide a definitive airway.
The rescue breathing now is simply out of habit. Cultural inertia. It'll be phased out completely soon enough.
It's sort of like spinal precautions for trauma patients. Backboards and C-Collars don't actually help anybody. But the lawyers expect them to be used, so they're used.




K-man said:


> As to the Heimlich manoeuvre, it is now out too.



That's still the heimlich, they just don't call it by that name anymore. Maybe Dr Heimlich wanted royalties.


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## Dirty Dog (Nov 6, 2012)

Carol said:


> For a few of us, high school was quite awhile ago.



WHAT????
Say it isn't so!!!!!


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## Carol (Nov 6, 2012)

Dirty Dog said:


> WHAT????
> Say it isn't so!!!!!



OKOK for me anyway.  But I still get carded. :lol:  :angel:


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