Chest thrusts are a life-saving technique used in specific choking emergencies. Understanding the correct area to perform these thrusts is important for effectively dislodging an airway obstruction. This method applies in situations where standard abdominal thrusts may not be suitable or effective.
Understanding When Chest Thrusts Are Necessary
Chest thrusts are used when standard interventions, such as abdominal thrusts (Heimlich maneuver), are not recommended. This includes situations where the choking person is pregnant, very obese, or unresponsive. For these groups, abdominal thrusts can be less effective or potentially cause harm.
The purpose of chest thrusts is to create an artificial cough by compressing the lungs, forcing air out to dislodge the foreign object. For adults, chest thrusts are typically performed when the rescuer cannot wrap their arms around the person’s abdomen due to their size or pregnancy. For infants, chest thrusts are part of the recommended sequence of interventions for choking, often alternated with back blows.
Pinpointing the Correct Anatomical Location
For adults, the correct area to perform chest thrusts is on the lower half of the breastbone, also known as the sternum. The rescuer places their fist in the middle of the chest, just above where the lowest ribs join, avoiding the xiphoid process. The other hand is placed over the fist to provide additional force. This placement helps to compress the lungs effectively without applying pressure to the softer abdominal area.
For infants younger than one year, the anatomical landmark for chest thrusts differs. The rescuer places two fingers, typically the index and middle fingers, in the center of the infant’s chest. This spot is located just below an imaginary line connecting the infant’s nipples. This precise location on the sternum allows for effective compression while minimizing the risk of injury to the infant’s delicate internal organs.
Performing Chest Thrusts Effectively
For an adult, the rescuer stands behind the choking individual. They wrap their arms around the person’s chest, placing a fist with the thumb side against the middle of the breastbone. The other hand grasps the fist, and quick, forceful thrusts are delivered straight back into the chest. The goal of these thrusts is to generate enough pressure to expel the obstruction from the airway.
For infants, performing chest thrusts involves careful positioning and technique. The infant should be placed face-up on a firm surface or held securely along the rescuer’s forearm, ensuring their head is lower than their chest. Using two fingers placed on the designated spot below the nipple line, five rapid chest thrusts are given. Each thrust should compress the chest about 1.5 inches (4 cm) deep, allowing the chest to fully recoil before the next thrust. These chest thrusts are typically alternated with five back blows until the object is dislodged or the infant becomes unresponsive.
Safety Considerations and Next Steps
Performing chest thrusts carries potential risks, including the possibility of broken ribs or internal injuries due to the force applied. Therefore, it is important to use these techniques only when there is a clear and severe airway obstruction. Even if the obstruction is successfully cleared, the individual should seek medical attention promptly to assess for any potential complications or injuries.
If the choking person becomes unresponsive at any point, emergency medical services should be called immediately. For adults, the response transitions to cardiopulmonary resuscitation (CPR), starting with chest compressions. If an infant becomes unresponsive, CPR should be initiated, focusing on chest compressions to help clear the airway. Professional medical evaluation is important after any choking incident, regardless of the outcome.