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Choking - child
 A choking child needs first aid to prevent them losing consciousness.
First, encourage the child to dislodge the obstruction by coughing. If this does not clear it, apply the following techniques in sequence until the child is able to breathe freely again.
First stage - back blows
Bend child forwards and give up to five blows between shoulder blades with heel of your hand
Check mouth for removable obstruction
Second stage - abdominal thrusts
Stand or kneel behind child, bend them forwards and put your arms around their upper abdomen
Place your fist against lower part of child's breastbone
Grasping fist with your other hand, pull sharply upwards and inwards, trying with each thrust to clear the obstruction
Check mouth for obstruction
Repeat up to five times, if necessary
Third stage
If the obstruction still hasn't cleared, continue a cycle of five back blows and five abdominal thrusts up to three times.
Further actions
If the child is still in difficulties, call for emergency help. If the child loses consciousness, begin resuscitation.
See babies choking if the child is less than a year old.
Choking - adults
Choking can result in the loss of consciousness but is often not as serious as this.
What is it?
A severe obstruction is when a person is unable to speak, cry, cough or breathe. A mild obstruction is when a person finds it difficult to breath, but is able to speak, cry, cough or breathe. They are able to clear the obstruction without help.
First aid aims
Relieve the obstruction
Arrange for medical help if necessary
Actions
If the obstruction seems to be mild, get the casualty to continue coughing.
If the obstruction is severe, follow this pattern
First stage - back blows
Give up to five blows between the shoulder blades with the heel of your hand
Check the mouth quickly after each one and remove any obvious obstruction
Second stage - abdominal thrusts
If obstruction is still present, give up to five abdominal thrusts
Place a clenched fist above the casualty's navel, grasp your fist with your other hand and and pull inwards and upwards
Check the mouth quickly after each one
Third stage
If obstruction does not clear after three cycles of back blows and abdominal thrusts, dial 999
Continue until help arrives and resuscitate if necessary
If casualty loses consciousness
Begin resuscitation and continue until help arrives
Panic attack
A panic attack is distressing for the person experiencing it and difficult to respond to, but it isn't harmful.
What is it?
A panic attack is a sudden rush of overwhelming fear that often occurs without warning or any obvious reason.
Symptoms
Hyperventilation and fast breathing result in lack of carbon dioxide in blood
Palpitations
Nervous behaviour
Difficulty swallowing or breathing
Trembling
First aid aims
Calm the casualty
Encourage them to regain control and seek medical advice
Actions
Take casualty to a quiet place
Be reassuring but firm
Remain with casualty until panic attack is over
Advise casualty to see their GP
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