Choking: 'I thought she was dying'

When her daughter started choking, the terrifying few minutes that followed showed Kate Hilpern just how unprepared we are for this common emergency. She shares the lifesaving advice every parent should know

My three-year-old daughter loves blueberries almost as much as she loves ice cream. So one day when we'd come in from the weekly shop, I decided to push the boat out and give her both for pudding. She grinned as she held up her first spoonful to show me. The next thing I knew, she couldn't breathe.

The smoothness of the ice cream must have made the blueberry slide down her throat, where it lodged in her windpipe. Her arms and legs started moving in a frenetic, almost involuntary way I'd never seen before.

Her mouth was frozen wide open and her eyes were begging me for help. Scariest of all was the silence. The blockage was so airtight that she couldn't cough, shout or even splutter.

As I grabbed her out of her chair, I realised I hadn't got a clue what to do. Why, oh, why had I never got round to a bloody first aid course? Shaking, I reached for the phone, but who should I call? And did I have time? I threw the phone to the floor and acted on instinct instead. I sat on the stairs, leaned her forward and started whacking her back.

Nothing. When I turned her face towards me, it had turned a deep shade of scarlet and her eyes were bulging and watery. I began to wonder if she might die. I have never felt so desperate. I tried again. And again. And then it happened – the blueberry flew across the floor, landing under the radiator. She burst into tears and so did I.

We were lucky. Choking is the third most common cause of infant death in the UK, after road traffic accidents and house fires. This March, a boy of seven months died after choking on a marshmallow during a family meal at a restaurant in Hertfordshire. The same month saw parents of a toddler speaking out after the inquest of their toddler son, who died after choking on a piece of sausage while eating his lunch at a nursery in Huddersfield. He was left so brain damaged that four days later, they made the agonising decision to turn off his life-support machine.

One in two people don't know what to do when someone chokes, according to St John Ambulance.

"You could say the fact that half of all people do know what to do seems good. But actually it's really bad that more don't because the action you need to take is so simple," says Isobel Kearl, first aid development officer for St John Ambulance.

She adds that if it's your own child choking, you are inevitably going to panic. No question. "If you know how to respond, it gives you something definitive to do."

If the child is over 12 months old and coughing, she says, you should always let them continue. "It's the body's way of ridding itself of the object. The problem comes if they can't make any noise. That's the point at which to lean them forward, support them with your arm and hit them between the shoulder blades using the heel of your hand."

So far so good with my own instinct, then. The trouble would have come if the blueberry hadn't flown out, for you're only supposed to hit them up to five times. After that, you try the same number of abdominal thrusts.

"This basically involves standing behind the person and making a fist with your thumb inside your hand," explains Kearl. "Place it just above their belly button, then bring your other hand round the body and pull in and up in a scooping motion. If you've ever seen Mrs Doubtfire, you'll probably remember the scene when she does it."

If the thrusts don't clear the blockage (it's important to keep an eye on the floor in case you miss it), return to five of the back blows, repeating the cycle three times. That's the time to call an ambulance, continuing the cycle until the person becomes unconscious, at which point you need to start CPR.

The only difference with a child under 12 months is that you lay them face down along your forearm, with their head low, to do the back blows, and turn them over onto your arm, with the head still low, to do the abdominal thrusts – which should be done using two fingers in the middle of the chest pushing inwards and upwards. There's no time to waste. When choking occurs and the airway is blocked for 90 seconds to two minutes, brain damage can occur; after three minutes the person can die – as Louise Hill knows only too well. Her six-year-old son Toby suffered a serious brain injury that left him unable to walk or talk after picking a grape off another child's plate when he was two.

"I always cut up grapes for him and when I saw him take it, I was especially anxious because he was laughing. I was worried that would mean he'd swallow it whole. He did," she says.

Louise's instinct was to call an ambulance immediately and luckily for her, they arrived quickly. Her thumps to his back hadn't worked and so even by the time they arrived an incredible three minutes later, Toby was already unconscious. "But they said they could feel a faint heartbeat and that night, when he was in hospital, they thought he would be ok. They said that by morning, he'd have a sore throat, but that would be about it. But the next day came and he didn't wake up.

Almost a week later, they discovered he had fewer reflexes than a newborn baby and was in pain, so he was transferred to Great Ormond Street Hospital. Even three months after the accident, he couldn't see or voluntarily control any of his movements. He couldn't hold his own head or stop dribbling. Largely thanks to the Children's Trust, Toby has now started talking again and he can even take a step, albeit with support. "But he has no safety reflexes or balance and his concentration isn't good," says Hill.

About half of all choking accidents in young children involve food, with sweets and fish-bones the most frequent culprits. The number of incidents involving small parts from toys is also rising.

"Young children learn about the world around them by putting things in their mouths – it's part of normal development," explains Sheila Merrill, public health adviser for the Royal Society for the Prevention of Accidents (ROSPA). "But their airways are narrow and they don't yet have a full set of teeth."

No wonder prevention is seen as better than cure, with the Child Accident Prevention Trust advising parents of young children to particularly avoid ice cubes, nuts, whole grapes and large chunks of apple. "Hot dogs are often described as the perfect plug for a child's airway," adds chief executive Katrina Phillips, who says children should never walk around while eating and that you should always watch them, occasionally mimicking an exaggerated chewing action.

But with the best will in the world, you can't always escape risk, which is why it's so surprising that so many parents, like me, aren't clued up.

Sam Donkin has no doubt her first aid training – which she has to do because she runs a nursery school – saved her daughter's life. "She was about 15. We were in a restaurant and she suddenly went blue and couldn't breathe. I tried the blows and the thrusts that you're supposed to for what seemed like an eternity. There was a mirrored wall in front of her and she said she thought that was the end of her life. But one final really hard knock dislodged this bit of meat. I shudder to think what would have happened if I hadn't known what I did."

First aid courses range from three hours to several days and many specialise in infant and child first aid, but the take-up isn't as large as you'd think.

"Mostly it's because people think they won't need it or it won't happen to them," says Joe Mulligan, head of first aid at British Red Cross.

"But I think with some parents, there is a reluctance to learn because they don't want to confront the idea that they may need to use it on their own children. We get lots of parents signing up only after they've had a scare."

Like me. And despite Mulligan claiming that you can also learn a lot from first aid videos online, I've booked my morning of training for next month. I'm not taking any chances again. But I still can't quite work out how a researcher like me hasn't even researched what to do if my child is at risk. Every day, an estimated 40 under-five-year-olds are hospitalised after choking, so I admit I'm feeling very ashamed.

Choking in children and adults

The British Red Cross advises the following for anyone over one year old.

* Give five back blows between the shoulder blades with the heel of your hand.

* Check the mouth quickly after each one and remove any obvious obstruction.If the obstruction is still present:

* Give up to five abdominal thrusts. Place a clenched fist between the navel and the bottom of the breast bone and pull inwards and upwards. Check the mouth quickly after each one. If the obstruction does not clear after three cycles of back blows and abdominal thrusts, dial 999 (or 112) for an ambulance.

* Continue cycles of back blows and abdominal thrusts until help arrives and resuscitate if necessary. Any casualty who has been given abdominal thrusts must seek medical advice.

Burns : Cool the affected area by holding it under running cold water for at least 10 minutes. If the pain continues, put it back. This calms swelling and stops the area continuing to burn. Remove clothing, but if any is stuck to the burn, leave it on. Use either a clean, non-fluffy cloth or cling film for a dressing and no matter how small the burn, get it checked out, because a child's skin is far more sensitive than an adult's.

Nose bleed: Lean the child's head forward to allow blood to drain, and pinch the bottom part of the nose (not the bridge) to encourage the blood to clot. Continue for 10 minutes, reapplying for two further sessions of 10 minutes if the bleeding doesn't stop. If there is still bleeding after 30 minutes, get the child to casualty or the GP.

Broken, strained or sprained bones: If the bone is broken, keep the person still, in the same position you found them and get help. If it's a sprain or strain, use RICE – Rest, Ice, Compress (using a firm bandage) and Elevate. If you can't tell, assume it's broken.

Electric shock : Don't touch your child if they're still in contact with the electric source as you could get electrocuted through them. Switch off the electric current if you can. If you can't, move the child by standing on some dry insulation material, such as a phone directory, and then take something made from non-conductive material (wooden broom or newspaper, for instance) and push the electric source away. Check their breathing and apply CPR if necessary. Call an ambulance as even small electric burns can cause internal damage.

Seizures: Parents usually assume this is epilepsy and panic, but any child whose temperature rises too high can get a febrile seizure. Place soft things around the child so they can't hurt themselves and don't try to restrain them. Once they have stopped being stiff, they will start to shake and feel very tired – now remove their clothing and fan them down. Call an ambulance.

Life and Style
love + sex A new study has revealed the average size - but does that leave men outside the 'normal' range being thought of as 'abnormal'?
Arts and Entertainment
The Palace of Westminster is falling down, according to John Bercow
voices..says Matthew Norman
Steve Bruce and Gus Poyet clash
Life and Style
ebookNow available in paperback
ebookPart of The Independent’s new eBook series The Great Composers
Graham Norton said Irish broadcaster RTE’s decision to settle was ‘moronic’
Arts and Entertainment
Jake and Dinos Chapman were motivated by revenge to make 'Bring me the Head of Franco Toselli! '
arts + ents Shapero Modern Gallery to show explicit Chapman Brothers film
Arts and Entertainment
Kurt Cobain performing for 'MTV Unplugged' in New York, shortly before his death
music Brett Morgen's 'Cobain: Montage of Heck' debunks many of the myths
Life and Style
Brendan Rodgers
football The Liverpool manager will be the first option after Pep Guardiola
Amazon misled consumers about subscription fees, the ASA has ruled
Arts and Entertainment
Myanna Buring, Julian Rhind-Tutt and Russell Tovey in 'Banished'
TV Jimmy McGovern tackles 18th-century crime and punishment
Arts and Entertainment
Paul Whitehouse as Herbert
arts + ents
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Lettings and Sales Negotiator - OTE £46,000

    £16000 - £46000 per annum: Recruitment Genius: This is an opportunity to join ...

    Recruitment Genius: Home Care Worker - Reading and Surrounding Areas

    £9 - £13 per hour: Recruitment Genius: This is a great opportunity to join a s...

    Recruitment Genius: Key Sales Account Manager - OTE £35,000

    £25000 - £35000 per annum: Recruitment Genius: Have you got a proven track rec...

    Recruitment Genius: Sales Executive - OTE £40,000

    £15000 - £18000 per annum: Recruitment Genius: This is a great opportunity for...

    Day In a Page

    Syrian conflict is the world's first 'climate change war', say scientists, but it won't be the last one

    Climate change key in Syrian conflict

    And it will trigger more war in future
    How I outwitted the Gestapo

    How I outwitted the Gestapo

    My life as a Jew in wartime Berlin
    The nation's favourite animal revealed

    The nation's favourite animal revealed

    Women like cuddly creatures whilst men like creepy-crawlies
    Is this the way to get young people to vote?

    Getting young people to vote

    From #VOTESELFISH to Bite the Ballot
    Poldark star Heida Reed: 'I don't think a single bodice gets ripped'

    Poldark star Heida Reed

    'I don't think a single bodice gets ripped'
    The difference between America and Israel? There isn’t one

    The difference between America and Israel? There isn’t one

    Netanyahu knows he can get away with anything in America, says Robert Fisk
    Families clubbing together to build their own affordable accommodation

    Do It Yourself approach to securing a new house

    Community land trusts marking a new trend for taking the initiative away from developers
    Head of WWF UK: We didn’t send Cameron to the Arctic to see green ideas freeze

    David Nussbaum: We didn’t send Cameron to the Arctic to see green ideas freeze

    The head of WWF UK remains sanguine despite the Government’s failure to live up to its pledges on the environment
    Author Kazuo Ishiguro on being inspired by shoot-outs and samurai

    Author Kazuo Ishiguro on being inspired by shoot-outs and samurai

    Set in a mythologised 5th-century Britain, ‘The Buried Giant’ is a strange beast
    With money, corruption and drugs, this monk fears Buddhism in Thailand is a ‘poisoned fruit’

    Money, corruption and drugs

    The monk who fears Buddhism in Thailand is a ‘poisoned fruit’
    America's first slavery museum established at Django Unchained plantation - 150 years after slavery outlawed

    150 years after it was outlawed...

    ... America's first slavery museum is established in Louisiana
    Kelly Clarkson: How I snubbed Simon Cowell and become a Grammy-winning superstar

    Kelly Clarkson: How I snubbed Simon Cowell and become a Grammy-winning superstar

    The first 'American Idol' winner on how she manages to remain her own woman – Jane Austen fascination and all
    Tony Oursler on exploring our uneasy relationship with technology with his new show

    You won't believe your eyes

    Tony Oursler's new show explores our uneasy relationship with technology. He's one of a growing number of artists with that preoccupation
    Ian Herbert: Peter Moores must go. He should never have been brought back to fail again

    Moores must go. He should never have been brought back to fail again

    The England coach leaves players to find solutions - which makes you wonder where he adds value, says Ian Herbert
    War with Isis: Fears that the looming battle for Mosul will unleash 'a million refugees'

    The battle for Mosul will unleash 'a million refugees'

    Aid agencies prepare for vast exodus following planned Iraqi offensive against the Isis-held city, reports Patrick Cockburn