A 10-month-old suddenly becomes unable to cry or cough while playing with small toy parts. He is conscious but making no sound, with silent ineffective breathing efforts. What is the correct immediate sequence of actions?
- A Five back blows followed by five chest thrusts ✓
- B Blind finger sweep followed by abdominal thrusts
- C Five abdominal thrusts followed by five back blows
- D Immediate endotracheal intubation before any maneuvers
Correct answer: A. Five back blows followed by five chest thrusts
Explanation
Silent cough and inability to vocalize indicate complete foreign body airway obstruction requiring immediate relief. In infants under 1 year, the sequence is five back blows between the scapulae alternating with five chest thrusts using two fingers, repeating until relieved or the infant becomes unconscious. Abdominal thrusts are contraindicated in infancy because of liver and stomach injury risk, blind finger sweeps may impact the object deeper, and intubation delays clearance.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.