How To Deal With Choking and Allergy in Children?

Dr Orly Dafni Attia – Head of Paediatrician at Raffles Medical in Ho Chi Minh city had provide a talk about Choking and Allergy in Children. Click here to read more.

 

CHOKING IN CHILDREN

Thousands of babies are choking every year due to blockage of the Trachea. Small objects: marbles, beads, button batteries are just the right size to get stuck in child’s airway and cause choking.  

Not allowed :

Nuts and seeds
Popcorn
Hard candies
Hard not cooked: vegetables- carrot
Cylinder foods: cucumber, sausage, grape   

Children from 1-5 years old often put objects in the mouth because they are exploring the world. 

How to recognise a choking child?

  • Coughing
  • Crying
  • Gasping
  • Gurgling Sounds
  • Pale/Blue Lips, Face

How to help a choking child?
  • If you can see the object, try to remove it. Don’t poke blindly or repeatedly with your fingers. You could make things worse by pushing the object further in and making it harder to remove. 
  • If you can see the object, try to remove it. Don’t poke blindly or repeatedly with your fingers. You could make things worse by pushing the object further in and making it harder to remove. 
  • DON’T LEAVE  THE CHILD ALONE
  • If your child’s coughing isn’t effective (it’s silent or they can’t breathe in properly), shout for help immediately and decide whether they’re still conscious.
  • If your child’s still conscious, but they’re either not coughing or their coughing isn’t effective, use back blows.

BACK BLOW FOR CHILDREN UNDER 1 YEAR

  • Sit  down  and  lay your baby face  down along  your  thigh,  supporting  their  head with your  hand.
  • Give  up to  5  sharp back  blows with the  heel  of  1  hand in the  middle  of  the back between  the  shoulder  blades.

BACK BLOW FOR CHILDREN OVER 1 YEAR
 

  • Lay a small child face down on your lap as you would a baby.
  • If this isn’t possible, support your child in a forward-leaning position and give 5 back blows from behind.

If back blows don’t relieve the choking and your baby or child is still conscious, give chest thrusts to infants under 1 year or abdominal thrusts to children over 1 year. This will create an  artificial cough, increasing pressure in the chest and helping to dislodge the object.

CHEST THRUSTS FOR CHILDREN UNDER 1 YEAR

  • Lay your baby face up along the length of your thighs.
  • Find the breastbone and place 2 fingers in the middle.
  • Give 5 sharp chest thrusts (pushes), compressing the chest by about a third.

ABDOMINAL THRUSTS FOR CHILDREN OVER 1 YEAR

  • Stand or kneel behind your child. Place your arms under the child’s arms and around their upper abdomen.
  • Clench your fist and place it between the navel and ribs.
  • Grasp this hand with your other hand and pull sharply inwards and upwards.
  • Repeat up to 5 times.
  • Make sure you don’t apply pressure to the lower ribcage, as this may cause damage.
Click here to watch a video about How to help a choking child
 

ALLERGY IN CHILDREN

  • Allergy is hyper-reaction of the immune system against different agents.
  • Usually immune system can recognize agents that may harm the body like virus or bacteria  and attack them.
  • Sometimes it “confused” and attack an agents that has no harm to the body ( pollen, food = allergen).
 

  • Combination of genetic – hereditary factors  with exposure to allergens.
  • Sometimes first exposure to allergen can be very mild, even un – noticeable. On this event  immune – memory is created and in the  second exposure will have allergic reaction.
  • 1 in 5 people will have allergy.
Allergens
Inhaled – flower pollen, house  dust (mite), mold, cat fur.
Food- digest or even smell (in severe cases)
Nuts, strawberry, mango, egg, sesame
Medications – penicillin
Insect bites-bees 
Symptoms: 

  • Hay Fever – usually seasonal
  • Nasal congestion, itchy eyes, sneezing
  • Atopic Dermatitis – presenting symptom rash on the skin, redness, itchiness, peeling of the skin. (Atopia – not in place in Greece)
  • Food allergy – can be presented in may ways- itchiness in the mouth, swelling lips, tongue and throat, red rash till extreme reaction called anaphylactic shock.
  • Insect bites – can start from a local reaction of redness and swelling, itchiness that spread all over the body till full body rash, swelling of face, shortness of breath till anaphylactic shock.

Severe

•Swollen mouth
•Trouble
•Breathing or
•Speaking
•Wheezing
•Tummy ache
•Nausea
•Vomiting,
•Diarrhea
•Dizziness,
•Fainting

Anaphalaxis

  • Severe  allergic reaction can be life threatening.
  • Can start with feeling  dizzy, fast drop in blood pressure,  shortness of breath and  respiratory  distress, rash, swelling and edema of  airways- till chocking  and losing consciousness.
Diagnosis

•Skin tests with drops
•Blood tests – specific IgE
•Skin prick test-patches

How to prevent allergy?

Avoid – if known allergen, or minimize  exposure.
Keep an oral antihistamine available at all times.
For a history of SEVERE allergies, keep the injectable epinephrine on-hand and instruct your child/caregiver on proper use of it at all times

 

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