A 3-year-old boy is found choking by his mother after ingesting an earring. His mother immediately rushes him to the hospital. What emergency measures should the nurse do for a child who has aspirated a foreign object?

Abdominal thrusts


•Aspiration occurs most frequently with infants and toddlers. When a child aspirates a foreign object, the immediate reaction is choking and hard, forceful coughing. Usually, this dislodges the object. However, the risk remains that the airway may become completely obstructed and require intervention.

If the child is talking or coughing, do not interfere. Allow the victim to clear the airway by coughing while you observe for signs of airway obstruction. If the child is unable to make a sound due to airway obstruction, you must act to relieve the obstruction.

•For a child, perform abdominal thrusts (Heimlich maneuver) until the object is expelled or the victim becomes unresponsive.

•For an infant, deliver repeated cycles of 5 back blows (slaps) followed by 5 chest compressions until the object is expelled or the victim becomes unresponsive.

•If a child presents with complete airway obstruction (ie, is unable to speak or cough), dislodgement using back blows and chest compressions in infants, or the Heimlich maneuver in children, should be attempted. 

•If the victim becomes unresponsive, activate the emergency response system and start CPR with chest compressions (do not perform a pulse check). After 30 chest compressions, open the airway to look for the foreign body. If you see it, remove it, but do not perform blind finger sweeps because they can push obstructing objects farther into the pharynx. Attempt to give 2 breaths and continue with cycles of chest compressions and ventilations until the object is expelled.

•Incorrect: A finger sweep should ONLY be done on an unconscious patient if an object is visible. Never perform a blind finger sweep.

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