AIRWAY AIRWAY OBSTRUCTIONOBSTRUCTION

INFORMATION AND INFORMATION AND PREVENTIONPREVENTION

TRAINING OBJECTIVESTRAINING OBJECTIVES

Recognize the dangers of airway Recognize the dangers of airway obstructionobstruction

Identify ways adults can prevent Identify ways adults can prevent choking in young childrenchoking in young children

Identify ways adults can prevent Identify ways adults can prevent strangulation in childrenstrangulation in children

Identify ways adults can prevent Identify ways adults can prevent suffocation in childrensuffocation in children

TRAINING OBJECTIVESTRAINING OBJECTIVES

Recognize the dangers Recognize the dangers associated with the choking associated with the choking gamegame

AIRWAY SAFETYAIRWAY SAFETY According to Safe Kids USA, According to Safe Kids USA,

airway obstruction is the number airway obstruction is the number one cause of unintentional injury-one cause of unintentional injury-related death among infants related death among infants under the age of 1. under the age of 1.

Injuries occur when children are Injuries occur when children are unable to breathe normally unable to breathe normally because food or objects block because food or objects block their internal airways (choking).their internal airways (choking).

When materials block or cover When materials block or cover children’s external airways, children’s external airways, they will suffocate. they will suffocate.

When items become wrapped When items become wrapped around a child’s neck and around a child’s neck and interfere with breathing, interfere with breathing, strangulation will occur. strangulation will occur.

Choking, suffocation and Choking, suffocation and strangulation are all forms of strangulation are all forms of airway obstruction.airway obstruction.

Young children, especially Young children, especially under the age of three, under the age of three, are particularly vulnerable are particularly vulnerable to airway obstruction to airway obstruction injury and death due to injury and death due to the small size of their the small size of their upper airways, their upper airways, their relative inexperience with relative inexperience with chewing and their natural chewing and their natural tendency to put objects in tendency to put objects in their mouths. their mouths.

AIRWAY OBSTRUCTION-AIRWAY OBSTRUCTION-RELATED FATALITIESRELATED FATALITIES

In Missouri, in 2006, seven children over the age of one year died of unintentional airway obstruction injuries; of those, three were young children under the age of four years.

In 2006, a 14-month old was In 2006, a 14-month old was sleeping on a couch with an sleeping on a couch with an older, much larger sibling. She older, much larger sibling. She was apparently wedged between was apparently wedged between the back of the couch and the the back of the couch and the cushion, and suffocated.cushion, and suffocated.

In 2006, a 16-year old In 2006, a 16-year old accidentally hung himself while accidentally hung himself while playing a “choking game,” playing a “choking game,” which produces a feeling of which produces a feeling of euphoria or being high.euphoria or being high.

PREVENTING CHOKINGPREVENTING CHOKING The majority of airway The majority of airway

obstruction deaths are due to obstruction deaths are due to choking. The American Academy choking. The American Academy of Pediatrics suggests not of Pediatrics suggests not feeding children under the age of feeding children under the age of 4, round, firm food unless it is 4, round, firm food unless it is chopped completely. Round, firm chopped completely. Round, firm foods are often choking hazards. foods are often choking hazards. Choking can occur when infants Choking can occur when infants and young children do not grind and young children do not grind or chew their food and then try or chew their food and then try to swallow it whole.to swallow it whole.

The American Academy of The American Academy of Pediatrics lists the Pediatrics lists the following foods as being following foods as being choking hazards: choking hazards:

▪ ▪ Hot dogsHot dogs

▪ ▪ Nuts and seedsNuts and seeds

▪ ▪ Whole grapesWhole grapes

▪ ▪ Chunks of meat or Chunks of meat or cheesecheese

▪ ▪ Hard, gooey, or sticky Hard, gooey, or sticky candycandy

▪ ▪ PopcornPopcorn

▪ ▪ Chunks of peanut butterChunks of peanut butter

▪ ▪ Raw vegetablesRaw vegetables

▪ ▪ Fruit chunks, such as Fruit chunks, such as applesapples

▪ ▪ Chewing gumChewing gum

The American Academy of The American Academy of Pediatrics lists the Pediatrics lists the following household items following household items as being choking hazards: as being choking hazards:

▪ ▪ BalloonsBalloons

▪ ▪ CoinsCoins

▪ ▪ MarblesMarbles

▪ ▪ Toys with small partsToys with small parts

▪ ▪ Small ballsSmall balls

Toys that can be squeezed Toys that can be squeezed to fit entirely into a child’s to fit entirely into a child’s mouthmouth

Pen or marker capsPen or marker caps Small button-type Small button-type

batteriesbatteries Medicine syringesMedicine syringes

The American Academy of The American Academy of Pediatrics lists the following Pediatrics lists the following guidelines to prevent choking: guidelines to prevent choking: Learn CPRLearn CPR Be aware that balloons pose Be aware that balloons pose a choking risk to children up a choking risk to children up to 8 years of age to 8 years of age

Keep foods that can cause Keep foods that can cause choking away from children choking away from children until 4 years olduntil 4 years old

Insist that children eat at the Insist that children eat at the table, or at least while sitting table, or at least while sitting down down

Children should not run, walk, Children should not run, walk, play, or lie down with food in play, or lie down with food in their mouths their mouths

Cut food for infants and Cut food for infants and young children into pieces no young children into pieces no larger than one-half inch, and larger than one-half inch, and teach them to chew their food teach them to chew their food well well

Be aware of older children’s Be aware of older children’s actions. Many choking actions. Many choking incidents occur when older incidents occur when older brothers or sisters give brothers or sisters give dangerous food, toys, or small dangerous food, toys, or small objects to a younger sibling. objects to a younger sibling.

Avoid toys with small parts, and Avoid toys with small parts, and keep other small household keep other small household items out of the reach of items out of the reach of infants and young children. infants and young children.

Follow the age guidelines on toy Follow the age guidelines on toy packages. Age guidelines reflect packages. Age guidelines reflect the safety of a toy based on any the safety of a toy based on any possible choking hazard as well possible choking hazard as well as the child’s physical and as the child’s physical and mental abilities at various ages. mental abilities at various ages.

Do not let infants and young Do not let infants and young children play with coins. children play with coins.

Check under furniture and Check under furniture and between cushions for small between cushions for small items children could find and put items children could find and put in their mouths. in their mouths.

PREVENTING PREVENTING STRANGULATIONSTRANGULATION

According to Safe Kids USA, According to Safe Kids USA, strangulation can occur among strangulation can occur among children when consumer children when consumer products become wrapped products become wrapped around their necks. Common around their necks. Common items include clothing items include clothing drawstrings, ribbons or other drawstrings, ribbons or other decorations, necklaces, pacifier decorations, necklaces, pacifier strings, and window blind and strings, and window blind and drapery cords. drapery cords.

Children can strangle in Children can strangle in openings that permit the openings that permit the passage of their bodies, passage of their bodies, yet are too small for, and yet are too small for, and entrap their heads. These entrap their heads. These include spaces in bunk include spaces in bunk beds, cribs, playground beds, cribs, playground equipment, baby strollers, equipment, baby strollers, carriages, and high chairs. carriages, and high chairs.

Safe Kids USA suggests the Safe Kids USA suggests the following guidelines to following guidelines to prevent strangulation in prevent strangulation in children: children: Remove hood and neck Remove hood and neck drawstrings from all drawstrings from all children’s outerwear. Never children’s outerwear. Never allow children to wear allow children to wear necklaces, purses, scarves or necklaces, purses, scarves or clothing with drawstrings clothing with drawstrings while on playgrounds.while on playgrounds.

Tie up all window blind and Tie up all window blind and drapery cords, or cut the ends drapery cords, or cut the ends and retrofit with safety tassels. and retrofit with safety tassels. The inner cords of blinds should The inner cords of blinds should be fitted with cord stops. Never be fitted with cord stops. Never place a crib near a window. place a crib near a window.

Do not allow children under the Do not allow children under the age of 6 to sleep on the top bunk age of 6 to sleep on the top bunk of a bunk bed. Make sure all of a bunk bed. Make sure all spaces between the guardrail spaces between the guardrail and bed frame, and all spaces in and bed frame, and all spaces in the head and foot boards, are the head and foot boards, are less than 3.5 inches.less than 3.5 inches.

PREVENTING PREVENTING SUFFOCATIONSUFFOCATION

According to Safe Kids USA, sixty According to Safe Kids USA, sixty percent of infant suffocation occurs percent of infant suffocation occurs in the sleeping environment. in the sleeping environment. Infants can suffocate when their Infants can suffocate when their faces become wedged against or faces become wedged against or buried in a mattress, pillow, infant buried in a mattress, pillow, infant cushion or other soft bedding or cushion or other soft bedding or when someone in the same bed rolls when someone in the same bed rolls over on them. over on them.

Infants can also suffocate when Infants can also suffocate when their noses and mouths are pressed their noses and mouths are pressed against a plastic bag. against a plastic bag.

According to Safe Kids According to Safe Kids USA, children have USA, children have suffocated when they have suffocated when they have become trapped in become trapped in household appliances, household appliances, such as refrigerators or such as refrigerators or dryers, and toy chests. dryers, and toy chests.

Safe Kids USA offers the following Safe Kids USA offers the following guidelines to preventing guidelines to preventing unintentional suffocation: unintentional suffocation: Place an infant on his/her back Place an infant on his/her back

on a firm, flat crib mattress in a on a firm, flat crib mattress in a crib that meets national safety crib that meets national safety standards. Remove pillows, standards. Remove pillows, comforters, toys, and other soft comforters, toys, and other soft products from the crib. Never products from the crib. Never hang anything on or above a hang anything on or above a crib with string or ribbon longer crib with string or ribbon longer than 7 inches.than 7 inches.

THE CHOKING GAMETHE CHOKING GAME In America more and more In America more and more

children are becoming attracted children are becoming attracted to the “Choking Game.” to the “Choking Game.” Unfortunately, this is not a game. Unfortunately, this is not a game. It can have serious It can have serious consequences, such as: consequences, such as: SeizuresSeizures Brain Death/DamageBrain Death/Damage Retinal Hemorrhaging or StrokeRetinal Hemorrhaging or Stroke Unexpected DeathUnexpected Death

According to a study released According to a study released by the Centers for Disease by the Centers for Disease Control (CDC) in 2008, the Control (CDC) in 2008, the choking game involves choking game involves intentionally trying to choke intentionally trying to choke oneself or another in an effort oneself or another in an effort to obtain a brief euphoric to obtain a brief euphoric state or “high.” If state or “high.” If strangulation is prolonged, strangulation is prolonged, serious injury or death can serious injury or death can result. result.

The CDC study found most The CDC study found most fatalities from the choking fatalities from the choking game occurred among game occurred among those 11 years to 16 years those 11 years to 16 years old; the average age was old; the average age was 13. Choking game deaths 13. Choking game deaths were identified in 31 were identified in 31 states, it said.states, it said.

According to the CDC, warning According to the CDC, warning signs a child has been engaging signs a child has been engaging in the choking game include: in the choking game include: Marks on the neckMarks on the neck Severe headachesSevere headaches Bloodshot eyesBloodshot eyes Disorientation after spending Disorientation after spending

time alonetime alone Ropes, scarves, and belts tied to Ropes, scarves, and belts tied to

bedroom furniture or doorknobs bedroom furniture or doorknobs or found knotted on the floor or found knotted on the floor

Parents and adults should Parents and adults should talk to children and teens talk to children and teens about the choking game. about the choking game. Children may not know Children may not know that this activity can kill that this activity can kill them or leave them brain them or leave them brain damaged. damaged.

For More Information, For More Information, Visit These Websites:Visit These Websites:

Safe Kids USA,Safe Kids USA, http://www.usa.safekids.org/tier3_cd.cfm?folder_id=540&content_item_id=991

http://www.usa.safekids.org/tier3_cd.cfm?folder_id=301&content_item_id=21470

American Academy of Pediatrics, http://www.aap.org/publiced/BR_Choking.htm

For More Information, For More Information, Visit These Websites:Visit These Websites: Centers for Disease Control Centers for Disease Control

(CDC), (CDC), http://www.cdc.gov/mmwr/prehttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm5706a1.htview/mmwrhtml/mm5706a1.htmm

The DB Foundation, The DB Foundation, http://www.chokinggame.net/http://www.chokinggame.net/

MO Department of Social MO Department of Social Services Services State Technical Assistance TeamState Technical Assistance Team

Address:Address:

PO Box 208PO Box 208Jefferson City, MO Jefferson City, MO 65102-020865102-0208

Telephone: Telephone: (573) 751-5980(573) 751-5980(800) 487-1626(800) 487-1626(8 a.m. to 5 p.m. (8 a.m. to 5 p.m. CST, Monday – CST, Monday – Friday) Friday)

Email:Email:

   dls.stat@dss.mo.gov