MedicalSutras
Chest Thrust

Chest Thrust

Medical Emergencies

Chest thrust is an alternative to abdominal thrust in some special situations for opening an obstructed airway.

Indications

  • Infant (less than 1 year): A combination of back slaps and chest thrust is the recommended protocol.
  • Pregnant victim.
  • Extremely obese victim.

Contraindications

  • Older victim.

Conscious Victim

The following steps are recommended if the obese or pregnant victim is conscious and either standing or sitting:

  1. Start with the questions "Are you choking?" and "Can I help you?" to confirm the airway obstruction and get consent.
  2. Stand behind the victim and place the arms directly under the armpits, encircling the chest.
  3. Grasp one fist with the other hand, placing the thumb side of the fist on the middle of the sternum, not on the xiphoid process or the margins of the rib cage.
  4. Stabilise yourself so as not to fall backward when the procedure is carried out.
  5. Perform backward thrusts until the foreign body is expelled or the victim loses consciousness.

Chest thrust against choking

Unconscious Victim

The following steps should be performed if the FBAO victim becomes unresponsive or is found unconscious:

  1. Place the victim in the supine position and contact emergency medical services as soon as possible.
  2. Begin basic life support with 30 chest compressions - prior to checking for a pulse.
  3. In the adult or child victim, each time you stop compressions to open the airway and deliver two breaths, open the victim's mouth wide and look in for the object.
  4. If the object is visible, remove it using either a Magill intubation forceps, cotton pliers, or fingers*.
  5. If the object is not visible, continue BLS with chest compressions, repeating steps 2 and 3 until the object is removed or emergency medical services arrive and take over management of the situation.

*Current guidelines do not recommend a blind finger sweep, as there are case reports documenting harm to the victim or rescuer.

References

  • Medical Emergencies in the Dental Practice (7th Edition), Stanley F. Malamed, Daniel L Orr II, Mosby Elsevier. https://amzn.to/4bsbBkf.
  • The image used is in public domain (Source : Wikimedia Commons).

*This article is an excerpt from the above mentioned books and Medical Sutras does not make any ownership or affiliation claims.