The common saying, ‘if you can talk, you can breathe,’ is often used as a quick assessment tool in first aid situations, particularly when someone appears to be choking. This phrase suggests that if a person can make sounds, their airway is not completely blocked, implying some air movement. While it provides a general guideline, understanding the nuances of airway obstruction is important for providing appropriate and timely assistance.
Understanding Airway Obstruction
Breathing relies on a clear pathway for air to reach the lungs. The respiratory system, including the nose, mouth, throat (pharynx), voice box (larynx), and windpipe (trachea), must be unobstructed for effective air exchange. When an object, like food, becomes lodged in this pathway, it causes an airway obstruction.
Airway obstructions can be either partial or complete. In a partial obstruction, some air can still move past the blockage. This partial airflow allows a person to cough, speak, or make sounds because enough air can pass through the vocal cords in the larynx to create vibrations. Conversely, a complete obstruction means no air can pass, preventing any sound production or effective breathing.
When Talking is Possible
When someone can talk or make sounds during a choking incident, it indicates a partial airway obstruction. While they can still breathe, they are experiencing distress, and their breathing may be noisy or wheezing. Their skin might appear flushed, but could become pale or bluish if oxygen deprivation worsens.
In such cases, encourage the person to cough forcefully. Coughing is the body’s natural and most efficient way to dislodge the obstruction. Observe them closely and avoid interfering with their attempts to clear their airway. Bending them forward at the waist can assist their coughing efforts.
When Talking is Not Possible
If someone cannot talk, cough, or make any sounds, it indicates a complete airway obstruction. They may clutch their throat, appear panicked, and their skin, lips, or nails might turn blue or gray due to lack of oxygen. Immediate action is important because a complete blockage cuts off oxygen to the brain, which can lead to unconsciousness.
For adults and children over one year, first aid involves five back blows followed by five abdominal thrusts (Heimlich maneuver). Back blows are delivered between the shoulder blades, while abdominal thrusts are quick, upward pressures just above the navel. These actions should be alternated until the object is dislodged or the person becomes unresponsive.
Knowing When to Seek Emergency Help
Calling emergency services is important in certain choking situations. If a person experiencing a partial airway obstruction cannot clear it with coughing, or if their condition worsens, emergency help should be summoned. For a complete airway obstruction, emergency services should be called immediately, especially if first aid attempts are unsuccessful or if the person becomes unresponsive.
If a choking person becomes unconscious, they should be lowered to the ground, and if trained, CPR should be initiated, starting with chest compressions. Even if the obstruction is cleared, a medical evaluation is recommended to ensure no internal injuries from the first aid maneuvers.