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How to know if your child's illness or injury is really an emergency

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A Grasshopper walks into a bar…

You know how some situations are so surreal that time seems to move in slow motion? Those moments in life where you think, “Gosh, this could be a sitcom I’m living in, because this can’t possibly be how real people behave?” I’m talking about stories that are so ridiculous you couldn’t possibly make them up because no one would believe you? It’s like a bad joke: a pediatrician, and ER doctor and a senior paramedic were sitting in a kitchen when a toddler started to choke. And no one moved. Ha ha!

Okay, so “choke” rhymes with “joke” but it’s not really funny. Although in retrospect the situation was like a B movie script. I had two great friends over last week, one of whom is a senior ER doctor just outside of London and the other was the first paramedic in Wales. These guys are two of the most seasoned emergency responders you will ever find. The ones you actually want sitting in your kitchen when your child chokes. And then there was little old me. I count for something, no? Here’s what happened:

I served the girls some dinner. Roast vegetables and hamburger, all cut into little bite size pieces. Oh and some ketchup. Everyone loves ketchup.

A couple of minutes later Eva started to cough. Or sort of wheeze and choke. She was still making noises, however, so I didn’t really rush to do anything, reasoning that she was still exchanging air. When she turned purple, I calmly undid her safety straps and picked her up, patting her on the back. And when she went a little blue, I flipped her upside down and gave her several firm whacks across the back. In the meantime I sort of wandered over to the door where my friends were sitting on the back porch.

“Just a little choking,” I said, as they looked up. And neither of them moved, calmly sipping their drinks and watching me. A few seconds later one of them said, “Well, isn’t she blue?” and finally stood up. Right about then Eva caught her breath and began to cry, completely pink again.

When a little one is choking, we in the medical profession often advise that you not move or disturb a child who is still making noise, because that means she is still moving air and if you upset her, she could close off her airway all together. On the other hand, when she didn’t recover quickly and the fact that she was turning blue was a sign that she wasn’t getting enough oxygen. And as for a kid who is truly choking, I won’t go into the details here because I don’t have room, but every parent, sitter and Grandparent should know basic choking first aid for both infants and toddler. Even though Eva is 19 months old, she’s still smaller than a 1 year old and that is why I treated her like an infant and administered back blows.

The funny part of this story is how unbelievably calm we all were, right up until the situation had resolved. I guess the three of us are so used to seeing emergencies and knowing we have to remain in our right minds in order to be of any help and so not used to these kinds of scenes outside the hospital that we were probably a little slower to react than anyone else would be. I will admit that once she was smiling again, my heart rate caught up to reality and I had a little moment of “what if!” And Eva sure wasn’t interested in any more hamburger that evening. We told her father later what had happened and he declared that he isn’t giving her any more meals until he’s had a first aid course. Which is probably a good idea. Unless, of course, his intention is to get out of cleaning the high chair…

Dr. Lara Zibners, May 19, 2011

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