As a family practice resident I was in to do a physical on a 7 year old boy, with mother and two other siblings who were 3,5 years old present. As I walked in I noted that the 3 year old brother to the patient was sucking on some candy and drooling all over his shirt and floor. The upper half of his shirt was completely soaked.
I kept on questioning the mother regarding the 7 year old but kept looking at how intensely the 3 year old was sucking his candy. All of a sudden, when I had just started the physical exam, the mother screams "Oh my god my child is choking". I swirled my head and sure enough the child had a blank face, mouth wide open, gasping. I stormed out of the room to ask for help but no one was there. I ran back in and instinct took over. I grabbed the child and flipped him stomach first on the palm of my hand and with his back facing me, I started to slap his mid back. He responded by covering the whole of my office floor with vomit. Within that vomitus was a large piece of red color plastic matter, roughly the width of a golf ball.
My heart was pounding out of my chest and then I noted that the mother seemed to be talking to me. I looked at her trying to follow her conversation. She had started exactly where we left off prior to this incident. Unbelievable. Did I miss something or did your son almost choke to death? was the question that I kept thinking about. Oh well. Maybe this was a regular issue at her home, kids choking on food.
The next week, I had an in-service exam and one of the questions, was almost my exact scenario. The choices were, back thrusts, Heimlich maneuver, finger swipe and something else, that I don't remember at this time. I answered back thrusts since I knew first hand that it actually works. WRONG. The correct answer is that anyone over 1 year of age gets Heimlich maneuver.
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