First Aid - Choking急救-窒息

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Wednesday, 06 February 2008星期三， 08年2月6日

Please call 911 immediately if you are having chest pain, difficulty breathing, severe bleeding, sudden weakness or numbness, or if you think you have a medical emergency.请立即拨打911 ，如果您有胸部疼痛，呼吸困难，严重出血，突发性的缺陷或麻木，或如果你认为你有一个医疗的紧急情况。

Choking Treatment窒息治疗

Self-Care at Home自我照顾家

Choking is an emergency. 窒息是一种紧急情况。 Call 911 emergency medical services. 拨打911紧急医疗服务。 Do not attempt to drive a choking person to a hospital emergency department. 不要尝试驾驶呛人到医院急诊室。

What to do if a person starts to choke: 怎么办如果一个人开始呛：

It is best not to do anything if the person is coughing forcefully and not turning a bluish color.最好不要做任何事情如果该人是咳嗽有力，而不是变成蓝色的颜色。 Ask, "Are you choking?"问： “你窒息？ ” If the person is able to answer you by speaking, it is a partial airway obstruction.如果该人能回答你的发言，这是一个部分气道阻塞。 Stay with the person and encourage him or her to cough until the obstruction is cleared.留在人，并鼓励他或她咳嗽，直至清除阻塞。
Do not give the person anything to drink because fluids may take up space needed for the passage of air.不要给任何人，因为饮用流体最多可能需要的空间需要通过空气。

Someone who cannot answer by speaking and can only nod the head has a complete airway obstruction and needs emergency help.有人谁可以不回答的发言，只能点头的头部有一个完整的气道阻塞，需要紧急帮助。

The treatment for a choking person who begins to turn blue or stops breathing varies with the person's age.治疗一个谁呛人开始把蓝色或停止呼吸随人的年龄。 In adults and children older than one year of age, abdominal thrusts (formerly referred to as the "Heimlich maneuver") should be attempted.在成人和儿童一年以上的年龄，腹部要点（原称为“海姆利克氏操作法” ）应尝试。 This is a thrust that creates an artificial cough.这是一个推力，创造一个人工咳嗽。 It may be forceful enough to clear the airway.这可能是有力的足够明确的气道。

The quick, upward abdominal thrusts force the diaphragm upward very suddenly, making the chest cavity smaller.快速，腹部向上的推力武力膈肌上升非常突然，使胸腔较小。 This has the effect of rapidly compressing the lungs and forcing air out.这已影响迅速压缩肺部，并迫使空气了。 The rush of air out will force out whatever is causing the person to choke.在繁忙的空中武力将出了什么导致人窒息。

How to perform abdominal thrusts 如何执行腹部要点

Lean the person forward slightly and stand behind him or her. Make a fist with one hand. 精益前进的人略有站在他或她。握拳用一只手。 Put your arms around the person and grasp your fist with your other hand in the midline just below the ribs.把你的双臂拥抱的人，抓住你的拳头与您另一方面在中线略低于肋骨。 Make a quick, hard movement inward and upward in an attempt to assist the person in coughing up the object.很快就做出了，硬运动抵港及向上，企图以协助该人咳嗽的对象。 This maneuver should be repeated until the person is able to breathe or loses consciousness.此动作应反复进行，直至该人是能够呼吸或失去意识。
If the person loses consciousness gently lay him or her flat on their back on the floor. 如果失去意识的人轻轻地躺在他或她的单位就其回到地板上。 To clear the airway, kneel next to the person and put the heel of your hand against the middle of the abdomen, just below the ribs.要清除气道，跪在旁边的人，把你的脚后跟一方面对中间的腹部，略低于肋骨。 Place your other hand on top and press inward and upward five times with both hands.请将您的另一方面的顶端，然后按抵港及向上的5倍，两手都要硬。 If the airway clears and the person is still unresponsive, begin CPR.如果气道清除的人仍然没有反应，开始复苏。
For babies (younger than one year of age), the child will be too small for abdominal thrusts to be successful. 至于婴儿 （年龄小于1岁），儿童将太小，腹部主旨是成功的。 Instead, the infant should be picked up and five back blows should be administered, followed by five chest thrusts.相反，婴儿应挑选了五回的打击应该是管理，其次是胸部五个重点。 Be careful to hold the infant with the head angled down to let gravity assist with clearing the airway.要小心举行婴儿的头部角度，以让重力帮助清除气道。 Also be careful to support the infant's head.还必须小心，以支持婴儿的头部。 If the infant turns blue or becomes unresponsive, CPR should be administered.如果婴儿满蓝色或变得反应迟钝，心肺复苏术应该管理。
If you are in doubt about what to do , 如果您是在怀疑做什么， and you are witnessing someone choking, call for emergency help immediately, do not delay.你看到有人哽咽，要求立即紧急帮助，不要拖延。 You may be able to successfully stop the choking before help arrives using techniques discussed here, but it is best for the choking person to be evaluated by the emergency medical team when they arrive.您可以成功地阻止窒息帮助到达之前使用的技术这里讨论，但它是最好的呛人进行评估，紧急医疗小组到达时。 If something is still in the person's throat, the emergency medical team can begin care immediately and take the person to the hospital for further treatment.如果事情仍然是在人的喉咙，紧急医疗团队可以立即开始照顾，并采取亲自到医院进行进一步治疗。

Variations of abdominal thrusts for special circumstances:变化的腹部主旨的特殊情况：

The victim is seated: The maneuver may be performed with the victim seated. 受害者是坐着：演习可以是与受害人坐下。 In this instance, the back of the chair acts as a support for the victim.在这种情况下，后面的椅子作为一个支持受害者。 The rescuer still wraps his or her arms around the victim and proceeds as described above.在救援仍在包装纸他或她的武器在受害者和收益如上所述。 The rescuer will often have to kneel down.会的救援往往要下跪。 In the event that the back of the chair the victim is sitting in is too high, either stand the victim up or rotate the victim 90 degrees, so that the back of the chair is now to one side of the victim.如果在后面的椅子受害者是坐在太高，要么站在受害者或受害者旋转90度，使后面的椅子现在是一方受害者。
For small rescuers and large victims, particularly children rescuing an adult: Instead of standing behind the victim, have the victim lie down on his or her back. 对于小型和大型救援受害者，特别是儿童抢救成人：不是站在受害者，受害者已经躺下的他或她回来。 Straddle the victim's waist.跨受害者的腰部。 Place one hand on the belly, halfway between the belly button and the edge of the breastbone.一方面广场上腹部，中间肚脐和边缘的胸骨。 Thrust inward and upward.推力向内，向上。 This is the same technique used in unconscious people.这是相同的技术在无意识的人。
You are choking and you are alone: You may deliver an abdominal thrust on yourself. 您的窒息，你就有：您可以提供一种推力腹部上自己。 This can be done in one of two ways.这可以采取两种方式之一。
- You can deliver a true "self"–abdominal thrust with your own hands.您可以提供一种真正的“自我”腹部主旨与您自己的手中。 This is done by positioning your hands in the same fashion as if you were performing the maneuver on another person and delivering an inward and upward thrust.这是通过定位你的手以同样的方式是如果你表现手法上的另一人，并提供一个向内，向上的推力。
- Another option is to bend your belly over a firm object, such as the back of a chair, and thrust yourself into the object.另一种选择是弯曲你的肚子了坚实的对象，如后面的一张椅子上，自己和推力的对象。

You may pass out before you expel the object and before help arrives.你可以通过你以前的对象驱逐出境之前，帮助抵达。 In most communities, the 911 emergency system has what is known as enhanced 911.在大多数社区， 911应急系统所谓增强911 。 Whenever a call is placed through 911 to the dispatch center, the dispatcher has the phone number, address of the telephone, and owner of the line of the incoming call.每当有电话通过911放在派遣中心，调度员的电话号码，地址电话，并拥有行的来电。 This allows for rapid location of an incident and allows interrupted calls to be investigated.这样可以快速定位的事件，并允许中断的要求进行调查。

By dialing 911 and leaving the phone line open in communities where this protocol is followed, you could be ensuring the arrival of rescue personnel in the event your "self"–abdominal thrust fails to clear the foreign body and you do pass out.通过拨打911 ，让电话线开放社区的这一协议之后，你可以确保抵达救援人员在事件的“自我”腹部主旨没有明确的外国机构和你通了。 If the dispatcher has no response on an open line, the call must be investigated.如果调度没有任何反应，一个开放的路线，要求必须进行调查。

Check with your local police department and find out if your 911 dispatch center follows these procedures.请与您当地警察部门和了解您的911调度中心遵循这些程序。 If you live in a community that does not have a 911 system, check with your local police department both for the emergency number, and to find out if they follow these procedures.如果你生活在一个社会，没有一个911系统，请与您当地的警察部门都紧急号码，并找到他们是否遵循这些程序。

Pregnant/obese people: Abdominal thrusts may not be effective in people who are in the later stages of pregnancy or who are obese. 怀孕/肥胖的人：腹部目标可能无法有效人谁是后期怀孕或谁是肥胖。 In these instances, chest thrusts can be administered.在这种情况下，胸部重点可管理。 For the conscious person sitting or standing, take the following steps:为自觉的人或坐或站，采取以下步骤：
- Place your hands under the victim's armpits.请将您的双手下，受害人的腋窝。
- Wrap your arms around the victim's chest.总结各地的武器受害者的胸部。
- Place the thumb side of your fist on the middle of the breastbone.广场一侧拇指的拳头上中间的胸骨。
- Grab your fist with your other hand and thrust backward.抓斗您与您的拳头另一方面和主旨落后。 Continue this until the object is expelled or until the person becomes unconscious.继续这样做，直到物体或直至开除的人变得失去了知觉。
For the unconscious pregnant or obese person: The sequence of events is the same as those for an unconscious adult. 对于昏迷孕妇或肥胖的人：事件的顺序是相同的无意识的成年人。 Chest thrusts, rather than abdominal thrusts, are delivered.公益金重点，而不是腹部主旨，是交付。 To position yourself for chest thrusts, take the following steps:为了自己的立场胸部重点，采取以下步骤：
- Kneel on one side of the victim.跪在一方的受害者。
- Slide two fingers up the bottom edge of the rib cage until you reach the bottom edge of the breastbone called the xiphoid process.幻灯片两个手指的底部边缘的肋骨，直到您达到底部边缘的胸骨所谓的剑状的进程。
- With your two fingers on the xiphoid, place your other hand on the breastbone, just above your fingers.在你的两个手指的剑状，把您的另一方面的胸骨，略高于你的手指。 The thrusts should be quick and forceful to remove the object.的重点应迅速和有力消除的对象。
- Care should be taken because complications such as rib fractures and heart muscle damage have been known to occur with chest thrusts.应当注意，因为并发症，如肋骨骨折和肌肉损伤心脏已经知道发生在胸部重点。
- If at all possible, subdiaphragmatic (below the ribcage) abdominal thrusts should be used in the pregnant woman, especially if there is still room between the enlarging uterus and baby , and the rib cage to perform the maneuver.如果在所有可能的，膈下（以下ribcage ）腹部应重点用于孕妇，特别是如果仍有待扩大之间的子宫和婴儿，和肋骨进行军事演习。

Special Note: The American Heart Association and the American Red Cross (the two main certifying bodies for teaching medical professionals and lay-people about first aid) differ on the initial treatment of conscious adults who are choking. 特别注意：美国心脏协会和美国红十字会（两个主要认证机构的教学医疗专业人员和普通人的急救）不同的初步治疗成人意识谁是畅通。 The guidelines given above follow the American Heart Association recommendations.该准则遵循上述美国心脏协会的建议。 The American Red Cross guidelines include five back blows on conscious adults prior to administering abdominal thrusts.美国红十字会的指导方针，包括五个回来就意识到打击之前，成年人腹部管理重点。 This has been a controversial topic in the field of choking treatment for many years.这一直是一个有争议的话题领域的哽咽治疗多年。 There is scientific evidence for and against back blows as initial treatment in adults.有科学证据支持和反对打击后，作为初步治疗成年人。 For more information on this treatment variation please consult the American Red Cross website.欲了解更多有关这一治疗变异请查阅美国红十字会的网站上。

Medical Treatment医疗

Treatment begins when local emergency medical services (EMS) arrive on the scene.治疗开始时，当地的紧急医疗服务（ EMS ）到达现场。 They have several ways to treat a choking person.他们有几种方式来对待呛人。 In addition to being skilled in the choking treatment and CPR, they also may have several tools to assist them in clearing the airway.除了熟练的令人窒息的治疗和心肺复苏术，但它们也可能有一些工具，以协助他们清理气道。

Intubation : a breathing tube is passed into a person's windpipe (trachea).气管插管：一个呼吸管传递到一个人的气管（气管）。 This may push the object that is obstructing the airway out of the way enough to provide air to the lungs.这可能会推动对象，是阻碍了气道的方式，提供足够的空气到肺部。
- To perform intubation, a metal scope is inserted into the back of the throat to aid in seeing the vocal cords, which mark the opening of the trachea.如果要执行气管插管，金属范围是插入到后面的喉咙，以协助看到声带，这标志着开幕式气管。
- If, while using this scope, the object causing the obstruction can be seen, it may then be removed with a long instrument called a Magill forceps.如果同时使用此范围内，物体造成的阻塞可以看出，它可能会删除具有长期的文书称为Magill案件钳。
If attempts to intubate a person with a complete airway obstruction are unsuccessful, EMS personnel may have to perform a surgical procedure called a cricothyrotomy.如果企图插管一个人与一个完整的气道阻塞是不成功的，环境管理体系人员可能进行外科手术称为cricothyrotomy 。 This involves cutting the neck and making a hole in the trachea just below the Adam's apple, through which a breathing tube is inserted.这包括切割颈部和决策中的一个漏洞气管略低于喉结，通过呼吸管插入。 This tube should enter the trachea below the spot that is blocked by the foreign body.此管进入气管下方的位置是阻止异物。
Once at the hospital, a doctor may use a bronchoscope to remove the object.一旦在医院，医生可能会使用支气管镜，消除的对象。 Bronchoscopy involves inserting a flexible fiberoptic scope into the airway (trachea).支气管镜检查涉及插入一个灵活的光导纤维范围的呼吸道（气管）。 If something is found, this scope also has attachments that the doctor can use to remove the object.如果事情被发现，这个范围也有附件，医生可以使用删除对象。
- To perform this procedure, the person is heavily sedated and the nose numbed with a topical gel.要执行此过程，该人是大量镇静剂和鼻子麻木了专题凝胶。 The flexible scope is placed through the nose into the back of the throat and then guided into the trachea.灵活的范围是放在通过鼻子进入后面的喉咙，然后引导进入气管。
- Most people do not remember this procedure being done.大多数人不记得这个程序正在做。 It can be performed quickly if a person is in distress, and sedation is always used.它可以迅速完成，如果一个人处于困境，并镇静总是使用。
If all of these maneuvers fail, the choking person will be taken to the operating room to have the foreign body removed and a clear airway established surgically.如果所有这些演习失败，呛人将被带到手术室有异物移除，并明确设立气道手术。