1. ANNUAL COMPULSORY EDUCATION CHOKING

2. UNIVERSAL SIGN FOR CHOKING

3. LEARNING OBJECTIVES How to prevent choking What are the signs & symptoms of choking Techniques to aid a choking individual

4. TO PREVENT CHOKING Give enough time for the Resident to completely chew & swallow their food Do not mix food & fluids when feeding a resident Position the Resident up-right when feeding Have the Resident slightly tuck their chin when swallowing Sit down at the Resident’s level & face them when feeding Resident should not talk or laugh when their mouth is full of food Check Resident’s mouth for pocketing during & after meal time

5. SIGNS OF CHOKING Inability to speak, cough, or breath Change of color to the face (red then turns bluish) Look of panic with wide eyes, tears One or both hands clutching their throat May try to leave for a private area Acting agitated or trying to get attention

6. WHEN SOMEONE IS CHOKING If the Resident is coughing: Encourage them to keep coughing & stay close by Do not let the Resident go off on their own If the Resident is unable to cough: Ask the Resident “Are you choking?” If so, tell the Resident “I can help you.” Call “Help – Code Blue!” The first person to respond should be sent to page Code Blue

7. CHOKING MANEUVER Stand behind the Resident with one leg between theirs Slide your arm under the residents armpit Wrap the arm diagonally across the Resident’s chest Bend the Resident over at the waist until the Resident’s upper airway is parallel to the ground Deliver 5 firm back blows between the shoulder blades with the heel of your other hand If this does not dislodge the foreign object, move on to the next step…

8. CHOKING MANEUVER (STEP 2) Continue to stand behind the Resident Make a fist with one hand and place it just above the Resident’s belly button (to landmark place hands at the resident’s hips and slide towards the belly button) Place other hand over the fist & pull up sharply in & up  Do this 5 times Continue the cycle of 5 back blows & 5 abdominal thrusts until the foreign object is dislodged & the resident can cough &/or breathe, trained help arrives, or the resident becomes unconscious (5 back blows & 5 abdominal thrusts makes one cycle )

9. FOR A LARGER CHOKING RESIDENT Perform 5 firm back blows Wrap your arm diagonally across the resident’s chest while standing behind them by sliding your arm under the resident’s armpit Lean the resident forward at the waist (only to the point where you will not drop them) With the heel of your hand, perform 5 back blows between the shoulder blades If this does not dislodge the foreign object, move on to Step 2

10. FOR A LARGER RESIDENT (STEP 2) If you can not reach far enough around the resident to perform abdominal thrusts… Stand behind the resident with your leg between theirs Wrap both of your arms around the resident’s chest just under the armpits Make a fist & place the thumb side of the fist in the middle of the resident’s chest then place your other hand over your fist Pull straight back (sharply & deeply)towards you 5 times. Continue the cycle of 5 back blows & 5 chest thrusts until the foreign object becomes dislodged and the resident can cough/breathe, a trained rescuer arrives, or becomes unconscious

11. IN A WHEELCHAIR OR SEATED POSITION Lock the wheels of the wheelchair Kneel or crouch behind the wheelchair While standing behind the Resident make a fist with one hand and place the thumb side of the fist just above their belly button Grasp your fist with your other hand and pull sharply in and up 5 times. If this does not dislodge the foreign object, move on to Step 2

12. IN A WHEELCHAIR OR SEATED POSITION (STEP 2) Landmark your fist to the middle of the resident’s chest by sliding it from under the residents armpit Place your other hand over your fist & pull straight back sharply  Do this 5 times. Continue the cycle of 5 abdominal thrusts & 5 chest thrusts until the foreign object becomes dislodged and the resident can cough/breathe, a trained rescuer arrives, or becomes unconscious

13. UNCONSCIOUS RESIDENT Please Note: ****HCAs are not perform the choking maneuver on an unconscious resident or do CPR ***

14. BSF REQUIREMENTS Initial competency completed in General Orientation Six months from the date of hire Annual completion of Online Compulsory In-service (HCAs, OT/PT, ADP) Annual completion of Choking Competency (return demonstration) (this must be signed off by a nurse or the Education Department)