Monday, 21 October 2013

If your baby was choking, would you know what to do?

I'd finally stopped shaking but still felt the need to vomit. We were in the ambulance and Sofia Faith was peacefully sleeping in my arms. There was no sign of the trauma she had just come through.

I held her tightly and let the tears finally go.

The paramedic smiled at me kindly. I'm sure she sensed I felt so bloody guilty.

I pulled myself together, and began asking questions. What would happen when we arrived at the Royal Surrey Hospital? What exactly do they do when there's been a choking incident? And with an infant that is only ten months old?

I closed my eyes only to watch the scene replay in slow motion again.

We were over with a new friend of Esme's for a play date. The big girls had been caught in a whirl of dress-up and dance, having a ball. I had spent the time getting to know mum Andrea, while distracting Fia away from everything - as you do in a house where babies and toddlers are a thing of the past.

It had been a great couple of hours but now it was time to go home, and I was trying to convince my not quite four-year-old Esme that getting Fia back for her nap was more important than being a fairy. In the end I'd had to go into the bedroom to jolly her along and help her change.

I could see the carpet was peppered with all things girlie and given that Fia was a demon for putting things in her mouth, knew I couldn't take my eyes off her. But I had, and in the moment I did Esme's button up, it was too late. 

Fia let out a shrill scream and began choking before my eyes. She passed out briefly, before coming too and choking again.

I asked Andrea to phone an ambulance as I grabbed Sofia up into my arms, banging her on the back. Still she choked, and now I was panicked. I tipped her upside down. Nothing changed. Her lips were tinged blue.

Looking helplessly at Andrea, I garbled, 'I don't know what to do.'
'You've got to get it out,' she said firmly. We had no idea what 'it' was.
'I can't. Do something please?'  

What happened next was completely the wrong thing to do, I think we both knew that at the time too. But I guess even though the ambulance was coming, time mattered and we felt something else was needed.

In desperation Andrea carefully put her hand in Fia's mouth to try and dislodge whatever was blocking her airway. Suddenly Sofia gagged. Then she coughed up blood. And then amazingly, within a couple of moments, was fine. Completely back to normal.

As she wriggled out of my arms and on to the kitchen floor, I watched her crawl, babbling away as she did so. I sunk down, aware that my legs couldn't hold me up anymore. My entire self was enveloped in shock.

The paramedics arrived just in time to watch Sofia pull herself up against the fridge and reach for a small magnet. It was almost comical. Almost. They checked her over, before packing us both into the ambulance. 

Esme appeared totally unfazed; just delighted to be told she'd have the chance to change back into fabulous fairy garb. She waved me goodbye with a wand.

What if only her wand could have waved the clock back. I would never have put Sofia Faith down in the bedroom. I would have got Esme into the kitchen to change her dress. What if, what if. 

Simon had joined me at the hospital and fortunately for us, Sofia was absolutely fine. The hospital had x-rayed her lungs to make sure they were clear. The doctor convinced me that if something had been small enough to fit down her oesophagus into her tummy, it was also going to be small enough to pass out the other end. 

One concern still remained... I felt it had been a metallic hair clip and if it was, then surely that could do more harm on the way out? 

My fear was unfounded, for the doctor had examined Sofia, pressing down all over her abdomen and found her to be quite well. He had known exactly where it would be in her system only an hour after swallowing it, and knew that if there was something like a hair clip within, she would be in agony, crying and vomiting.

A little later, when the four of us were back home together and the girls were in bed, Simon and I sat chatting about the narrow escape we'd had. Of course, I continued to worry. 

Over the next 48 hours I waited for 'it' to pass though Sofia's system. Indeed, I trawled through each dirty nappy for the next week. Nothing ever did materialise, and I decided she must have brought whatever it had been up straight away when she first choked. Simon convinced me that it was not lodged somewhere internally, and eventually I relaxed.

Sofia is now just over two-years-old, and up until quite recently, continued to challenge me by putting absolutely everything in her mouth. A part of me wonders if it was because of the way I reacted that frightful day. I was not calm at all. I think she rather liked the attention she received as a consequence when it came to putting things in her mouth thereafter. Indeed, she only stopped putting small things in her mouth, when I stopped jumping up in a panic to remove whatever it was. 

WHAT TO DO if your baby is choking... 

Choking in babies under one year old
A baby who is choking will be distressed and may be unable to cry, cough or breathe.
  • Lie the baby face down along your forearm or thigh, with their head low. Support their head.
  • Give up to five firm slaps to the baby’s back between the shoulder blades with the heel of your hand. (The heel is between the palm of your hand and your wrist.)
  • Stop after each slap to check if the blockage has cleared. Look inside the baby’s mouth and remove any obvious blockage. Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage. You may push it further in.
  • If the airway is still blocked, give up to five chest thrusts (see below).
  • Stop after each thrust to check if the blockage has cleared.
If the baby’s airway is still blocked after three cycles of back slaps and chest thrusts, you should:.
  • dial 999 (or 112) for an ambulance immediately. Do not leave the baby. Take him or her with you to the phone 
  • continue with the cycles of back slaps and chest thrusts until help arrives

Chest thrusts for babies under one year old

In babies under one year old, chest thrusts are used in an emergency to clear a blockage from their airway. Important: do not use abdominal thrusts with babies under one year old.
  • Lie the baby along your forearm on their back, with their head low. Support their back and head.
  • Give up to five chest thrusts. Using two fingers, push inwards and upwards (towards the head) against the baby’s breastbone, one finger's breadth below the nipple line.
  • Check if the blockage has cleared after each thrust, by looking inside the baby’s mouth and removing any obvious blockage. Do not poke your fingers into the baby’s mouth unless you can see and reach the blockage as you may push it further in. 

Complications

Once the baby’s airway is cleared, some of the material that caused the blockage can sometimes remain and cause complications later. If the baby still has a persistent cough or difficulty swallowing, they need to see a health professional urgently. You should take the baby to A&E, an NHS Walk-in Centre or your GP if it’s during GP hours.


NB. These are the current choking guidelines for babies under one-year-old, as provided by the NHS.

In the meantime, it is worth remembering that having FIRST AID training could make a difference. Click here to find a course near you.