A nurse observes circumoral cyanosis in an infant who is choking. Which of the following actions should the nurse take?
A.
Move the infant into an upright position and suction the airway with a bulb syringe.
B.
Deliver back blows with the infant face down over the rescuer’s arm.
C.
Place the infant in a side-lying position and perform abdominal thrusts.
D.
Perform a head tilt and a chin lift and then give two rescue breaths.
Circumoral cyanosis (bluish discoloration around the mouth) in an infant who is choking is a sign of compromised airway and potentially severe respiratory distress. The priority in this situation is to clear the airway obstruction.
Here are the appropriate actions:
B. Deliver back blows with the infant face down over the rescuer’s arm.
Explanation:
- A. Move the infant into an upright position and suction the airway with a bulb syringe: While suctioning can be useful in some cases of airway obstruction, it is not the first step in the management of a choking infant. The priority should be to dislodge the obstruction.
- B. Deliver back blows with the infant face down over the rescuer’s arm: This is the correct initial action. For an infant who is choking, you should hold the infant face down on your forearm, supporting the head and neck, and deliver up to five back blows between the shoulder blades with the heel of your hand. This action can help dislodge the obstruction.
- C. Place the infant in a side-lying position and perform abdominal thrusts: Abdominal thrusts (Heimlich maneuver) are not recommended for infants. Instead, you should perform chest compressions if back blows do not clear the obstruction.
- D. Perform a head tilt and a chin lift and then give two rescue breaths: The head tilt and chin lift maneuver is used for unresponsive infants, but if the infant is choking, the priority is to clear the obstruction with back blows and chest thrusts rather than rescue breaths.
In summary, for an infant who is choking and exhibiting circumoral cyanosis, the correct action is to:
B. Deliver back blows with the infant face down over the rescuer’s arm.