1. DO NOT perform these steps if the infant is coughing forcefully or has a strong cry – either of which can dislodge the object on its own.
2. Lay the infant face down, along your forearm. Use your thigh or lap for support. Hold the infant’s chest in your hand and jaw with your fingers. Point the infant’s head downward, lower than the body.
3. Give up to 5 quick, forceful blows between the infant’s shoulder blades. Use the heel of your free hand.
IF OBJECT ISN’T FREE AFTER 5 BLOWS
1. Turn the infant face up. Use your thigh or lap for support. Support the head.
2. Place 2 fingers on the middle of his breastbone just below the nipples.
3. Give up to 5 quick thrusts down, compressing the chest 1/3 to 1/2 the depth of the chest.
4. Continue this series of 5 back blows and 5 chest thrusts until the object is dislodged or the infant loses consciousness.
IF THE INFANT LOSES CONSCIOUSNESS
If the child becomes unresponsive, stops breathing, or turns blue:
Shout for help.
Give infant CPR. Call 911 after one minute of CPR.
Try to remove an object blocking the airway ONLY if you can see it.
DO NOT interfere if the infant is coughing forcefully, has a strong cry, or is breathing adequately. However, be ready to act if the symptoms worsen.
DO NOT try to grasp and pull out the object if the infant is conscious.
DO NOT perform these steps if the infant stops breathing for other reasons, such as asthma, infection, swelling, or a blow to the head.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.