CPR and other Choking Emergencies

It was a nice day out and the preschool kids, staff, and I decided to have a picnic outside on the picnic tables. While we were eating Jonathan (three) jumped up and before any of us could do anything he ran to the playground. Becca, my assistant, got up to get him when all of a sudden he started choking. I got up and ran to his side immediately. While staying calm I had Becca go to the other students and keep them calm. Jonathan is gagging so I know his airway is only partially blocked. The first thing I would do is try to get him to cough. If he can not clear it out by coughing then I will ask Becca to call 911 while I do back blows and chest thrusts.
Next, I need to kneel behind him and provide support by placing one arm diagonally across his chest and lean him forward. Then I’ll firmly strike him between the shoulder blades with the heel of my other hand to give five back blows. Then I wrap my arms around his waist. Next I make a fist with one hand and place the thumb side against the middle of his abdomen, just above the navel and well below the lower tip of his breastbone. Then I grab my fist with my other hand and give five quick thrusts into the abdomen. I continue alternating five back blows and five abdominal thrusts until the object is dislodged (babycenter.com).
Since I am not supposed to move him, I sit with him until emergency personnel shows up. While they are with Jonathan, I will call his parents and talk about a plan of action. I will then call for a backup teacher and meet where the parents want to meet. His parents want to meet at the hospital but my backup teacher has not shown up yet so I have to stay with my students. I reassure Jonathan that he will be alright and that the EMT’s are going to take care of him and when he gets to the hospital his mom and dad will be there. When the incident is all over and I am free to fill it out, I need to fill out an accident report. I will study it to see if there was anything that could have been avoided through better safety practices.
Monica is eighteen months old and she is fairly new to my preschool. She has separation issues from her parents. Every time they drop her off she screams and has a tantrum. I have heard from a doctor before that if they have tantrums and they turn blue and stop breathing to just let them go and they will come back on their own. Well this one time, she did not. I rushed to Monica’s side immediately. She fell to the floor from passing out from not breathing. I had Becca sit with the other kids and keep them calm while I worked on Monica.
First I gently tapped on her shoulder and called out her name and she did not respond so I had Becca call 911. I checked to make sure she was not bleeding anywhere from hitting the floor then I tilted her head back with one hand and lifted her chin slightly with the other. This opened her airway. I checked for signs of life for about ten seconds. Then I check her breathing by putting my head down close to her mouth with my face towards her feet. I do not see her chest rising and she still is not breathing so I give her two gentle breath, about one second a piece. Then I pinch her nose shut, place my mouth over hers, and exhale into her lungs until I see her chest rise. I give her two breaths in a row, pausing between rescue breaths to let the air flow back out.
Next I place the heel of one of my hands on her sternum at the center of her chest. I place my other hand directly on top of the first hand and try to keep my fingers off her chest by interlacing them or holding them upward. Next I give her 30 chest compressions at the rate of one hundred per minute. Then give her two rescue breaths. If this does not work then I repeat the sequence of 30 chest compressions and two breaths and continue the cycle until she breaths or emergency personnel show up (babycenter.com). While the EMT’s are with Monica, I call her parents to talk about a plan of action ( Robertson, 2010). They want to meet us at the school and ride to the hospital with their daughter. I sit with Monica until they arrive. I call for a backup teacher and accompany them to the hospital. When all is well at the hospital I fill out a report and study it to see if the incident could have been avoided through better safety practices. I realize that this was one mistake I would never do again. It was a simple mistake that should never have happened.
I believe that advanced planning is imperative in preschool and daycare because you never know when an emergency is going to occur. It can happen at any time and being prepared is beneficial. Just like the examples that I gave, if I did not have the training that was needed, I would not have been able to save Jonathan or Monica’s life. Every teacher or aide needs to know the steps to take to save a child’s life if the time ever comes.
It is also important that parents know about safety and they should have an emergency plan for their children as well. They should have a place for them to meet in case of a fire, or any other emergency. They should have emergency contacts next to the phone at all times just like teachers should. You may need a number right away and if you do it will be right there for you to find.
References
BabyCenter (2008), First aid for choking and CPR: An illustrated guide for age 12
Months and older, Retrieved December 27, 2009 from
http://www.babycenter.com/0_first-aid-for-choking-and-cpr-an-illustrated-guide-for-age-1_11241.bc
Robertson, C. (2010). Safety, nutrition, and health in early education (4th ed.).
Belmont, CA: Wadsworth/Cengage Learning.