In a conscious choking child, an upward thrust is applied to the upper abdomen with a fisted hand at a point just below the rib cage, what is this action called?

1. A

   Valsalva Maneuver

2. B

   Heimlich maneuver

3. C

   Jaw thrust maneuver

4. D

   Chin lift maneuver

Appeared in: MP CHO - 2022

Explanation

• The Heimlich maneuver, or abdominal thrusts, is the standard first-aid response for a conscious person (child over 1 year or adult) with a severe airway obstruction.
• The maneuver works by creating a burst of air from the lungs, similar to a cough, which helps to dislodge and expel the foreign object.
• The hand placement described—a fisted hand on the upper abdomen just below the rib cage—is the correct technique for performing this life-saving procedure.

Why Other Options Were Wrong

• Option A: The Valsalva maneuver involves forced expiration against a closed glottis. It is used to equalize ear pressure or manage certain heart rhythms, not to clear an airway obstruction.
• Option C: The jaw thrust maneuver is a technique used to open the airway of an unresponsive patient, especially when a neck or spinal injury is suspected. It does not involve abdominal thrusts.
• Option D: The chin lift (as part of the head-tilt, chin-lift maneuver) is used to open the airway in an unresponsive patient when no spinal injury is suspected. It lifts the tongue off the back of the throat but does not create a forceful expulsion of air.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain First aid for foreign body airway obstruction (choking) in a child as background academic context rather than a clinical decision trigger.
• Correctly identifying and performing the Heimlich maneuver is a critical skill for nurses and the general public, as it can be life-saving in a choking emergency.
• After successfully dislodging an object with the Heimlich maneuver, the person should always be evaluated by a healthcare professional. The force of the thrusts can sometimes cause internal injuries, such as damage to the liver, spleen, or ribs.
• What if the child becomes unresponsive? If a choking child loses consciousness, the rescuer should immediately stop abdominal thrusts, lower the child to the ground, call for emergency help, and begin CPR, starting with chest compressions. Before giving breaths, the rescuer should look inside the mouth for the object.

How to Approach the Question

• First, carefully read the question stem and identify the key actions described: 'conscious choking child', 'upward thrust', 'upper abdomen', 'fisted hand'.
• Recognize that these keywords describe a specific first-aid procedure for dislodging a foreign object.
• Evaluate each option based on your knowledge of basic life support and first aid.
• Eliminate options that are used for different purposes (e.g., Valsalva for pressure equalization, jaw thrust/chin lift for opening an airway in an unresponsive person).
• Select the option that precisely matches the described action, which is the Heimlich maneuver for choking.

Concept Tested & Keywords

• Concept Tested: First aid for foreign body airway obstruction (choking) in a child.
• Stem keywords: conscious choking child, upward thrust, upper abdomen, fisted hand
• Lead-in keywords: what is this action called
• Clinical cues: The description of the action (upward thrust to the upper abdomen) is a classic sign of a specific first-aid procedure.

Question ID

QRuegAYiWPGY6sCZ6UtwW

Copy ID

Reference Book

E6 Anatomy Applied Ashalatha 4e p. 96-98

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 763-765