CPR and Choking Emergencies

Choking scenario



You have just served lunch to your 3-year-old class. The children are eating hot dogs, when one of the children gets a piece of hot dog lodge in their throat. The child becomes stressed because very little air is passing through the airway. The child is now choking, the first thing the teacher must do is ask the child if they are ok. If the child is responds or is coughing, try to see if they can cough up whatever is blocking the airway. If the child cannot answer you or is unable to produce a productive cough, and tell the child calmly what you are going to try to help them. Depending on the size of the child, stand or kneel behind the child and place your arms around them. Make a fist with one hand; put the thumb side of your fist on the child’s abdomen above the navel but below the breastbone. Place your hand over the fist and give quick upward thrusts into the child’s abdomen until the object is removed. This maneuver is called the Heimlich. If the object is not forced out and choking persists causing the child to become unresponsive, then more serious action must be taken including 911 calls.



Head Trauma


The teacher has just taken the 4-year-old class out to the playground for recess. When one of the children, was playing on the jungle gym falls hitting their head on the ground, it results in a head injury. I am required to take action. The child is knocked unconscious and not breathing. The teacher should first ask the child if they are ok, then call 911. If the child is not responsive and is clearly unconscious, then check the airway. First look, listen, and feel for any breathing signs. If the teacher gets no breathing response then the tongue could be blocking the airway. Be very careful in trying to open the child’s airway. Use the head lift/chin lift technique to move the tongue out of the way. Once the airway is cleared but the child is still not breathing, the teacher must help the child breath. While the head is still tilted pinch the child nose and cover the child’s mouth with yours. Make sure you create a seal and give two breaths. Make sure the breaths are smaller as the child’s chest is small. After you do the two breathes and the child is still unresponsive, check for a pulse. The teacher will do this by placing two fingertips on the child’s carotid artery for approximately 3 to 8 seconds. If you do not fill a pulse the heart is not beating. It is now time to begin compressions. This must be done very carefully on a child and placement is crucial. The teacher must place two fingers at the bottom of the rib cage and place the heal of the other hand on top of the fingers. Rule of thumb is 30 compressions followed by two breaths. Make sure to do five cycles of this before checking for breathing and pulse or signs of consciousness. The only time CPR should be stopped is when EMS arrives.

Advance Planning

Advance planning is crucial when an emergency situation occurs. It is important that at least one staff member is properly trained in CPR and first aid as state law requires. It would be better if all staff members were trained properly in both CPR and first aid. If an emergency happens and only one person is trained and that person was not there that day then the emergency could have life-threatening complications, which could have been prevented, by just having every staff member trained properly in CPR and First aid. It is important that one if not all staff members are trained for all types of situations that could become an emergency, such as bee sting. Another way to have advance planning in an emergency situation is to have AED- (automated external defibrillator). This device is very expensive, and not all childcare centers will have them. All staff members should have training to know how to use it. When you are advance planning have a staff meeting for all staff to have an input on different scenarios that could happened and talk through how you would handle them then set guidelines for training in that scenario.

Preparedness of Crises

There are other steps adults must take to ensure they are prepared to handle these kinds of crises. It is important that if an emergency situation occurs you don’t want to become part of the problem. All situations need to be handled calmly and professionally. It is important to plan for adequate staffing and supervision. The Adult that is serving food needs to make sure that the food is appropriate size for young children. Make sure all parent phone numbers are up to date and medical authorization is in the file for each child. All first aid kits should be check weekly and well equipped for use. The adults should consider the developmental level of the children so is not to have activities above their developmental level. If transportation is used then the adult should make sure there is a working seat belt for every child. It is always good to go over safety tips with children so they are aware of what not to do.
In both cases one must be prepared for anything. Classes in first aid and CPR are very important and should be provided and required for all employees to maintain a safe environment for all children in the child care center or school.