Airway emergency - what would you have done.

Dave,

Obviously, you've provided some expert feedback. Thanks for the
reply. Your first paragraph is pretty much how I handled it, and
thank God I never had to progress too much further. I did try back
blows, which may or may not have been wise. I felt pretty helpless
even with the training I've had. In this case the back blows made no
difference. Every time I attempted to move myself into a position to
help if needed, I had problems controlling the airplane in the rough
air. I might have been able to keep my left hand on the right side of
the yoke and wrap my right arm around her waist, slide my fist up and
provide some modified thrusts. Don't know if I'd have moved much air
with that one armed procedure. It was if that candy was cemented in
place!

Every flight an adventure!

"Dave S" wrote in message
ink.net...
I would have asked her 1) are you choking? and if she nodded yes I
would
have asked 2) can you talk? and if she nodded no then I would have
intervened. OTherwise as long as shes moving air in SOME form or
fashion
I would let HER focus on clearing the obstruction and ME focus on
setting down somewhere if it didnt immediately clear.

If intervention were warranted (assuming a front seat passenger), I
would have attempted one or two modified abdominal thrusts (with
similar
direction and force as a heimlich). One or two thrusts will not
cause a
total departure from controlled flight in my opinion, and it might
provide enough effect to dislodge the obstruction. Thrust or two..
verify the plane is in control.. thrust again.. etc.. if it doesnt
clear
within a few moments of thrusting then its unlikely you will clear
the
obstruction in the air with lay skills. At that point, its purely a
personal decision what do do next.

Dave, RN, EMTP, PPSEL

The modified maneuver I was thinking of was flying with your feet (I
routinely use the rudders to maintain heading and bank on long XC's),
twisting towards the passenger seat and reaching across with the left
hand (as if to punch.) and thrust in/up between the navel and the
bottome of the sternum with the left hand/fist.

As with any kind of abdominal thrusts, you run the risk of laceration or
perforation of abdominal organs. However, these risks rarely (in my
mind) outweigh the immediate risk of death from a completely obstructed
airway.

Back blows really dont do a lot to increase intrathoracic pressure (and
blow out the obstruction) but may help shake loose the obstruction. They
are not recommended in the management of adult or child airway
obstructions by any credentialling organization that I'm aware of, but
the American Heart Association still teaches their use in the treatment
of infant obstructed airways.

If an ADULT has completely passed out and is unconscious from a total
airway obstruction (which is a truly grave situation) then blind finger
sweeps of the mouth and throat are part of the treatment regimen (Take a
CPR course sometime). In my experience with the average adult, you can
reach far enough back to feel the opening of the windpipe (* DO NOT DO
THIS ON SOMEONE WHO IS RESPONSIVE.. they will bite your fingers off!)

Again, I am limiting my interventions to what they lay person could be
expected to provied, and I must ask that this not be considered "medical
advice" but rather an opinion, and an encouragement to get proper lay
training in dealing with possible emergencies. American Heart and
American Red Cross are both excellent resources; for an introduction to
the more professional aspects of emergency health care you can check
with a local junior college or state board of health regarding First
Responder or EMT training in your area.

Dave

JJS wrote:

Dave,

Obviously, you've provided some expert feedback. Thanks for the
reply. Your first paragraph is pretty much how I handled it, and
thank God I never had to progress too much further. I did try back
blows, which may or may not have been wise. I felt pretty helpless
even with the training I've had. In this case the back blows made no
difference. Every time I attempted to move myself into a position to
help if needed, I had problems controlling the airplane in the rough
air. I might have been able to keep my left hand on the right side of
the yoke and wrap my right arm around her waist, slide my fist up and
provide some modified thrusts. Don't know if I'd have moved much air
with that one armed procedure. It was if that candy was cemented in
place!

Every flight an adventure!

"Dave S" wrote in message
ink.net...

I would have asked her 1) are you choking? and if she nodded yes I

would

have asked 2) can you talk? and if she nodded no then I would have
intervened. OTherwise as long as shes moving air in SOME form or

fashion

I would let HER focus on clearing the obstruction and ME focus on
setting down somewhere if it didnt immediately clear.

If intervention were warranted (assuming a front seat passenger), I
would have attempted one or two modified abdominal thrusts (with

similar

direction and force as a heimlich). One or two thrusts will not

cause a

total departure from controlled flight in my opinion, and it might
provide enough effect to dislodge the obstruction. Thrust or two..
verify the plane is in control.. thrust again.. etc.. if it doesnt

clear

within a few moments of thrusting then its unlikely you will clear

the

obstruction in the air with lay skills. At that point, its purely a
personal decision what do do next.

Dave, RN, EMTP, PPSEL