From the Guidelines
Elderly individuals who are choking and alone should raise their left hand high above their head as a universal signal for choking, and then attempt self-administered abdominal thrusts or press their abdomen forcefully against a firm object to dislodge the obstruction. This is based on the principles of recognizing and responding to foreign-body airway obstruction, as outlined in the 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care 1. The key to successful outcome is recognizing the signs of severe airway obstruction, such as a silent cough, cyanosis, or inability to speak or breathe, and intervening promptly.
Important Considerations
- The universal choking sign, which involves clutching the neck, can be used to verify that the victim has severe airway obstruction 1.
- After signaling for help, the elderly person should attempt to dislodge the obstruction using self-administered abdominal thrusts or by pressing their abdomen against a firm object.
- It is essential for elderly individuals to practice this technique before an emergency occurs, as quick action is crucial to prevent brain damage, which can begin within 4-6 minutes without oxygen.
- Family members and caregivers should also be trained to recognize the distress signal and respond appropriately, by calling for emergency help and attempting to dislodge the obstruction if possible.
Key Points to Remember
- Raise the left hand high above the head to signal for help
- Attempt self-administered abdominal thrusts or press the abdomen against a firm object to dislodge the obstruction
- Practice the technique before an emergency occurs
- Train family members and caregivers to recognize the distress signal and respond appropriately 1.
From the Research
Raising Left Hand for Choking in the Elderly
There is no direct evidence in the provided studies that specifically addresses raising the left hand for choking in the elderly. However, the studies do discuss various techniques for relieving foreign body airway obstruction (FBAO) in adults and children.
Techniques for Relieving FBAO
- Back blows: Studies suggest that back blows can be an effective technique for relieving FBAO, especially when used in combination with other maneuvers 2, 3.
- Abdominal thrusts: Abdominal thrusts are also recommended for relieving FBAO, although some studies suggest that they may not be as effective as back blows in certain situations 2, 3.
- Chest thrusts/compressions: Chest thrusts/compressions are another technique that can be used to relieve FBAO, and may be particularly effective in combination with back blows 2, 4.
- Body position: One study suggests that applying a prone or head-down position can increase the effectiveness of back blows and abdominal thrusts in relieving FBAO, due to the help of gravity 5.
Effectiveness of Interventions
- Early removal of FBAO by bystanders is associated with improved neurological survival 4.
- Key interventions, including back blows, abdominal thrusts, chest thrusts/compressions, and manual removal of obstructions, are effective in relieving FBAO, but may be associated with important harms 4.
- The effectiveness of interventions for FBAO relief is not well established, with very low evidence certainty for all interventions and associated outcomes 4.