Question

A 2-year-old child has choked on a peanut. What is the most appropriate immediate management?

• A. Chest compressions
• B. Back blows
• C. Abdominal thrusts
• D. Endotracheal intubation

Hint:

Choking child older than 1 year = abdominal thrusts. Infant below 1 year = back blows and chest thrusts.

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
The question addresses the emergency first-aid management of a conscious child over the age of 1 year who has a complete foreign body airway obstruction.
Step 2: Detailed Explanation:

Age-Based Management: For infants (under 1 year of age), management involves a combination of 5 back blows and 5 chest thrusts. Abdominal thrusts are contraindicated in infants due to the risk of liver or splenic injury.

Children over 1 year: For children older than 1 year (like this 2-year-old), the Heimlich maneuver or "abdominal thrusts" is the standard first-line procedure to dislodge a foreign body.

Mechanism: Abdominal thrusts create an artificial cough by rapidly increasing intrathoracic pressure, which can forcefully expel the obstructing object from the trachea or larynx.

Protocol for Conscious Patients: If the child can cough or speak, encourage them to cough. If the airway is completely obstructed (silent cough, inability to speak, cyanosis), perform abdominal thrusts until the object is expelled or the child becomes unconscious.

If Unconscious: If the child loses consciousness, start CPR, beginning with chest compressions. Intubation is difficult in the presence of a foreign body and should only be attempted by advanced providers if basic maneuvers fail.

Step 3: Final Answer:
For a 2-year-old child with an acute airway obstruction, abdominal thrusts (Heimlich maneuver) are the most appropriate immediate management.