الطريقة الطبية الصحيحة للتعامل مع من أصيب بالاختناق أو غُصَّ بشيء ابتلعه

كثيرًا ما يتعامل الأفراد بصورة خاطئة مع من يصابون بالاختناق، أو إعاقة في التنفس، أو يغصون بلقمة أو شيء يبتلعونه، وخصوصًا من الأطفال، مما قد يؤدي إلى وفاة المصاب، وهذا الخطأ يعود إلى عدم الدراية الكافية بالطريقة الصحيحة للتعامل مع من أصيب بنحو هذه الحالات، أو بالمسارعة بأحد الأعمال الخاطئة التي قد تزيد من خطورة الحالة، بدلاً من إنقاذ المصاب، كأن يضع المرء يده في فم المصاب، أو يلقيه على ظهره ويحاول استخراج ما سدَّ مجرى التنفس بأصبعه.فعندما يصاب المرء بالاختناق، ويحدث ما يمنع الهواء من المرور إلى الرئة لمدة ما بين دقيقة ونصف إلى دقيقتين، فإن المرء قد يصاب بتلف فوري في المخ، وإذا ما طالت المدة إلى ثلاث دقائق، فإن ذلك قد يؤدي - بإذن الله - إلى الوفاة.والطريقة الصحيحة التي نشرتها بعض المواقع البريطانية على صفحاتها الطبية؛ لإرشاد القراء إلى التعامل بالأسلوب الأمثل، إذا ما أصيب أحد الأطفال أو غيرهم بالاختناق، وفقد القدرة على الكلام، أو التنفس، أو لَفْظِ ما ابتلعه - هي العمل على الأخذ بالخطوات التالية:أ- من كان فوق سنة من العمر:1- أن يتمَّ الدفعُ خمسَ مرات بالكفِّ ما بين عظمتي لوح الكتفين.2- فإذا لم تُفلح الطريقة الأولى، فعلى المرء أن يقف خلف المصاب، ويحوط خصره بذراعيه ويثنيه إلى الإمام.3- قبض أصابع اليد، والضغط المتكرر على منطقة ما بين السرة ومنتهى عظام الصدر، والنظر إلى الفم مع كل مرة من الضغطات؛ لعل ما تسبب في الاختناق يكون قد لُفظ خارجًا.4- فإذا لم تفلح هذه الطرائق، فإنه يجب استدعاءُ عربة الإسعاف مع عدم التوقف عن الخطوات الثلاث السابقة باستمرار.5- يجب الكشف الطبي على المريض الذي تمَّ إنقاذُه؛ للتأكد من عدم التأثير السلبي من جراء الدفعات المتكررة.ب- الأطفال أقل من سنة:1- إذا ما أصيب الطفل الصغير بنحو الحالات السابقة، فإنه يُحمل على اليد ووجهه لأسفل، ويدفع على منطقة ما بين كتفيه من ظهره، ويُنظر في فمه مع كل مرة؛ لعل ما تسبب في الاختناق قد لُفظ في إحدى المرات.2- إذا لم تفلح الطريقة الأولى، فإنه يجب أن يُدفع الطفل في صدره خمس دفعات، بحيث يتم دفعُ الصدر مرةً، ثم ثنيُه إلى الأمام ورأسُه في مستوًى منخفضٍ مع كل مرة، لخمس مرات متكررة.بالإضافة إلى استخدام أصبعين للضغط على منطقة ما تحت مستوى حلمتي الثديين من الصدر مراتٍ متكررة.3- فإذا لم تفلح هذه الخطوات، فإنه يجب استدعاء عربة الإسعاف، مع الاستمرار على الخطوات السابقة.4- إذا ما كشف الله - تعالى - عن المصاب وعافاه، فإنه يلزم استشارة الطبيب؛ للتأكد من عدم حدوث آثار سلبية نتيجة الدفع والضغط المتكرر.

When my daughter choked on a sweet I fought to save her - and nearly KILLED her

We'd just arrived in France for a family holiday and were queuing to pick up an airport hire car when our six-year-old daughter Nathalie popped a marble-sized fruit gum into her mouth.She was playing a game with her twin brother and younger sister to see who could make their sweet last the longest. As the other two siblings quickly capitulated and started chewing, Nathalie opened her mouth and proudly displayed the intact sweet on the tip of her tongue.But when she put her tongue back into her mouth, the sweet must have flicked to the back of her throat - lodging in her windpipe.The next thing I heard was my wife Jo shouting: ‘Nathalie, are you OK?’My daughter was standing motionless, a startled look on her face, her mouth frozen wide open. She was rigid, unable even to point to her throat or indicate that she couldn’t breathe. Most terrifying of all was the silence.The blockage was so airtight that she couldn’t scream, cough or even splutter. As her face grew a deeper shade of red, I frantically put my arms around her stomach from behind, lifted her into the air and tried to lurch her forward, cack-handedly trying to displace the object.But to no avail. Her face turned redder and redder and her eyes started to bulge out of their sockets.And then another force took over. While my initial attempt at clutching Nathalie around the stomach and shoving her forward was a conscious act of desperation, my next actions felt more instinctive.Grabbing Nathalie from behind, I forced her left cheek against my stomach and shoved the index finger of my right hand into her mouth. I could feel the sweet tightly wedged at the entrance to her windpipe like a stopper rammed into a bottle.Without hesitation, I applied pressure to the wall of the windpipe to create a small space to the side of the sweet which I could poke my finger through. I hooked it around the sweet and violently yanked it out.As Nathalie started to breathe, the redness drained from her face. Feeling quite the hero, I wandered off to find the hire car and started loading it up. But as I put the last suitcase into the boot, my wife Jo dropped a bombshell.‘You do know that you should never put your fingers in someone’s mouth when they are choking.’I looked at her in astonishment.She had recalled something she’d been taught on a first aid course warning against using fingers to remove an obstruction because it can result in pushing the object farther down the windpipe - making it even harder to remove.I felt the onset of a new wave of panic. Instead of being a lifesaver, if my finger had been a fraction to the left or right I could, in my panic, have been the architect of a chillingly different scenario.We’d been lucky. Choking is the third most common cause of infant death in the UK, after road traffic accidents and house fires.Children who have recently lost their lives include three-year-old Ellie Conlon, whose seaside holiday ended in tragedy in Weston-super-Mare while eating a takeaway, and last year 11-year-old Sana Nadim from Manchester choked to death on a piece of chicken during her sister’s first birthday celebrations.It’s not just the young who are at risk. Last November, Strictly Come Dancing judge Len Goodman choked on a cough sweet backstage on the U.S. version of the TV show before he was saved by the quickwittedness of the show’s host. Using the Heimlich manoeuvre, he ejected the sweet from Goodman’s mouth.The technique is credited for saving thousands, including Cher, Elizabeth Taylor and Ellen Barkin.When choking occurs and the airway is blocked for 90 seconds to two minutes, brain damage can occur; after three minutes the victim can die. There are several courses of action for stopping someone choking, depending on the severity.If the victim can talk, then the airway is not completely obstructed and some air is getting through to the lungs. In this case, it is best to leave them alone until they can dislodge the food or stuck object themselves by coughing or throat clearing.If they cannot talk, it means the airway is completely obstructed and it’s vital to take immediate action (see box, below).When I replay the situation with Nathalie in my head, I try to convince myself that my response was not just blind desperation.I know that some sense and logic was applied; that I crooked my index finger along the inside of Nathalie’s cheek to avoid head-on contact with the blockage; that I felt the blockage first to assess where it was and whether I could squeeze my finger around the back of it to hook it out.But the reality is that I was just very, very lucky - and but for a millimetre in the wrong direction with my finger, Nathalie would not be smiling at me radiantly today with her big blue eyes, drinking up the beauty she sees in everything.