AIRWAY OBSTACLES

Asst. Prof. Dr. Gülay YAZICI

2021
 AIRWAY OBSTACLES
Airway obstructions are divided into two groups, anatomically and mechanically.

Anatomical Occlusion: It is an airway obstruction caused by the backlash of the

tongue of the patient / casualty who is unconscious or closed. Causes of obstruction;
acute asthma attack, pulmonary edema, contraction of breathing muscles, burns and
injuries.

Mechanical Occlusion: It is seen as a result of blocking the airway of blood or

coagulated saliva accumulating in the mouth. Mechanical blockages are mostly
caused by aspiration of stomach contents. A hard object stuck in the esophagus can
also create a mechanical blockage by pressing.
 1. Airway Obstruction Symptoms

In obstructions when anatomical or mechanical reasons occur;

dizziness, tachycardia, arrhythmia, inability to cough, central
cyanosis, inability to hear respiratory sounds,
signs of fainting, loss of consciousness, cardiac arrest and
dilatation of the pupils are observed.
2. First Aid and Emergency Care in Obstructions Due to Foreign
Substances
In airway obstructions caused by a foreign substance, the type of obstruction
should be determined first.
After determining the type of obstruction, it is vital to connect it to first aid
and emergency care equipment.
At this stage, the observation and removal of the foreign substance, which is
obstructing the airway, is important both for determining the diagnosis and
continuing the treatment.
Respiratory obstructions due to foreign substance are seen in two ways
(partial and complete obstruction).
 3. First aid and emergency care in partial obstructions

“Partial obstruction” occurs as a result of the foreign substance blocking the airway
causing a decrease in the air passage.

• The patient / casualty person with partial obstruction may cough or even speak.
• If the cough response is strong, it should be understood that there is sufficient air
exchange and the patient / casualty should be encouraged to cough.
• In the event that the obstruction continues, a whistling sound (wheezing) is heard
from the patient / casualty while breathing and cyanosis may be seen.
• Coughing patient / casualty should never be hit on their back.
 First Aid Practices in Partial Obstructions

Be sure of the safety of the patient or casualty.

If the patient / casualty is coughing, encourage them to cough.

Observe the exit of the foreign substance and, if breathing, give the
person a comfortable position.

Observe signs of complete obstruction in the unseen situation of

foreign substance.

Switch to first aid and emergency care practices as soon as possible.

 4. First Aid and Emergency Care in Complete Obstruction

Complete obstruction occurs when completely preventing the passage of the swallowed or
foreign substance escaping to the airway.
In addition, may occur due to the movement of the object during first aid and emergency
care applications of partial obstruction.

• The patient / casualty with complete obstruction cannot speak and answers questions with
head movements.
• Patient is in a panic and puts her hands on her neck.
• Patient cannot cough or breathe.
• Patient has cyanosis.
• Everyone over the age of 1 should be hit on the back and heimlich maneuver should be
applied if they are conscious.
 Heimlich Maneuver Technique
■ Dr. Developed by Dr.Henry Heimlich. It is a maneuver that tries to give movement to
the object by applying pressure to the abdomen. By compressing the lungs with the
pressure created, it contributes to the pushing of the air inside and the upward drag
of the body blocking the airway. After a few maneuvers, the object can be thrown
completely.
■ In advanced pregnancies and overweight people who develop respiratory
obstruction due to foreign substance, hands should be placed on the lower half of the
breastbone and pressure should be applied.
■ Although it is not seen as effective during pregnancy, it may harm the baby.
■ In an unconscious adult, the patient is placed in a lateral position while lying on the
ground and the back is hit 5 times. If the respiratory tract is not opened, the patient is
placed on a flat surface and his head is turned to the side.
■ 5 times compression are applied by the heel of one hand between the distal of the
belly and sternum over the patient's legs. This process continues until help arrives.
■ If the patient's respiratory tract is opened, the coma position is given and help
continues to be expected.
COMA POSITION
 Heimlich Maneuver Technique
■ The Heimlich maneuver in babies differs from those in other ages.
■ Maneuvering is possible in cases where the person is completely obstructed
and there is no person to apply the Hemlich maneuver.
■ When patient is sure that there is no helper, patient can apply the heimlich
maneuver to himself by taking a hand position as if s/he were applying an
assistant.
■ In cases where the foreign body does not come out with this method,
increasing the pressure applied to the abdomen with the help of a chair can
increase the movement of the object.
 Heimlich maneuver process steps in adults
STEPS
• Be sure of the safety of you, the patient / casualty.
• Shaking the patient / injured's shoulders, "Are you okay?" Ask and check his consciousness.
• Obtain information by observing the patient's posture and bringing his/her hands to her throat.
• Check the mouth and if you can observe the object, take it in one move.
• Stand behind the patient / casualty. Instruct the patient to lean forward, supporting the patient with one
hand.
• Try to move the foreign body by hitting hard five times between the scapulas by the heel of the hand.
• Check whether the foreign body reaches the mouth with the effect of these five strokes.
• If there is no foreign body after the back strike, perform a heimlich maneuver.
• With both arms, grasp the body by hugging the patient's back.
• Make a fist with one hand, thumb inside
• Place the thumb of the fisted hand between belly and the xiphoid process.
• Grasp the fisted hand with the other hand.
• Apply strong pressure to the back and upwards five times.
• Check whether the foreign body is removed under the effect of these five pressures.
• For the obstructed person, continue the application of five strokes to the back and five times of heimlich
maneuvers until the foreign body comes out.
• If the foreign body is removed and there is sufficient respiration, put the patient in a comfortable position
(orthopnea, fowler, coma position, etc.).
 Heimlich maneuver process steps in children
STEPS
• Be sure of the safety of yourself, the child.
• Holding the child's shoulders "Are you okay?" Check your awareness with the question.
• Observe the child's posture and put his/her hands to her throat.
• Check the mouth and if you can see the object, take it in one move (foreign body removal
practices in 8-year-olds are similar to adults).
• If you cannot observe the foreign object in the child's mouth, never dive blindly with a finger.
• Never use back hitting, abdominal thrusting and chest compressions for a child who is
coughing strongly.
• In case of partial obstructions, just observe the child until the obstruction is gone or complete
airway obstruction occurs.
• When you are sure that complete obstructin occurs, start the application.
• Decide whether you will do sitting or standing hemlich according to the child's development.
• Lay the child down carefully supported (even if no foreign body comes out).
• Be prepared for cardiopulmonary resuscitation (CPR).
 Heimlich maneuver process steps in infants
STEPS
✔ Make sure you and the baby are safe.
✔ Check the baby's awareness by giving painful stimuli.
✔ Determine the type of blockage by observing the signs of cyanosis in the baby.
✔ Give a head-chin position by grasping the baby's chin with the help of thumbs and other
fingers.
✔ After making sure that there is complete obstruction, give the baby a head-chin position,
and lay it on your prone arm.
✔ Tap with the inner part of the wrist five times between the baby's two shoulder blades.
✔ Turn over the other arm and check that the foreign substance is removed.
✔ After making sure that it does not come off, apply pressure by determining the CPR point
with two fingers 5 times, with the head below the body.
✔ Continue this process until the foreign substance comes out.
 DROWNING

Help should be called when the patient / casualty is sure that he has drowned in
water, and if the first aid worker is not trained, it should not be attempted to jump
into the water and rescue.
Drowning symptoms should be detected after the patient / casualty is removed
from the water.
These symptoms are; Difficulty in breathing, deep breathing, syncope, peripheral
and central cyanosis.
 Common Causes of Choking

■ Respiratory; It can be obstructed due to reasons such as tongue retraction,

loss of consciousness, foreign body, liquid or object that prevents air
passage.
■ Respiration may also stop due to cardiac arrest, shock, electric shock and
poisoning.
■ In addition, choking can occur as a result of toxic gases (carbon monoxide,
etc.), head injuries, and piercing objects in the chest wall.
 Choking Symptoms

There are different symptoms of drowning according to time.

The patient / injured in this situation should be given a head-jaw

position.
and
Rescue breathing should be applied within the first 3 minutes.
 Differences in symptoms of choking according to periods

First 30 minutes After 30 minutes

Dizziness and weakness, Central cyanosis
Dyspnoea, Superficial breathing
Tachycardia Bradycardia,
Partial loss of consciousness Complete loss of consciousness.
Fullness in the neck veins,
Peripheral cyanosis
Face blushing
 First Aid for Drowning

Procedures to be carried out on the patient / casualty

who suffered or drowned in the risk of drowning in
water ...
 Process steps in drowning
STEPS

• Get the patient / casualty in the water to the shore and lay them on their back.
• Loosen collar, belt.
• Remove dentures, if any.
• Clean the foreign objects inside the mouth.
• Give rescue breaths according to the characteristics of the patient / casualty.
• When exhaling, turn the person's head to the side and repeat this 5-6 times.
• Take off the patient / casualty's wet clothing and wrap them in a blanket.
• To remove swallowed water, take the position of the hemlich maneuver to be
applied to the unconscious patient and apply 5-6 compressions.
• Turn the patient's head to the side and observe the water exit.
THANK YOU...