Saving a choking victim on an airplane

U

Uncle Bill

Joined
Aug 24, 1999
Messages
434
OK so you're at 35,000 feet when someone two rows ahead of you gets an olive lodged in his windpipe.

A doctor without any equipment on him shouts, "Anybody got a knife?!!" What do you hand him so he can do the tracheotomy?

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Bill

"They'll say I was a musician, won't they?"
--Beethoven on his deathbed (and you thought nobody but you was insecure . . . )
 
If the victim is an attorney, another olive!

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"A conclusion is where you stopped thinking..."
 
Hmm...another silly "If situation X occured, what knife would you use" question. In this case though, my main knife would have been confiscated by security as I passed through the metal detector. Luckily, I have my Navigator attached to my keychain! The patient lives!
 
copfish,
LOL you slay me!
That was hilarious!

If it was a Dr. asking for a knife, I'd ask him where was his knife. No Dr. should ever be without a pocket knife even on a plane.

He'd either get my Cricket or my Emerson La Griffe.

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The individualist without strategy who takes opponents lightly will inevitably become the captive of others.


 
I don't think it's a silly question at all--for sure not any more silly than the threads that ask, "What do you carry as the back up to your back up's back up?"

(As though we should take seriously this person's belief that carrying four "tactical" knives is based on anything other than a romantic fantasy.)

Flame away!
smile.gif


[This message has been edited by Uncle Bill (edited 15 October 1999).]
 
Some of the smaller Victorinox SAK's have an "emergency blade" on them, as in emergency trachiotomy. My MiniChamp has one. I would rather someone just give me the Heimlich (sp?)! A small SAK is all you are likely to get on a lot of planes these days anyway.
Paul
 
Hah, you guys are taking this the WRONG direction! A savvy connoisseur of the 1970's era airport movies would recognize that by depressurizing the cabin one would have greater pressure in the choking victim's lungs than the cabin hence launching the olive forcefully into the back of the chair.

Clearly the knife to carry is not a fine razor sharp scalpel blade, but more of tanto style to puncture the cabin walls and windows! I suggest the CS CAT Tanto - wouldn't slow you down during those pesky security screenings….
 
I suspect that the doctor would use the scapel from the aircraft's advanced first aide kit.

Sorry, but they've already thought of that one, so don't try that as an excuse to carry your bowie through security.



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Chuck
Balisongs -- because it don't mean a thing if it ain't got that swing!
http://www.4cs.net/~gollnick
 
Scenario of a mid air hijack:

"Help! This man is choking. Stewardess, bring me the advanced first-aid kit. I'm a doctor."

Next thing you know, the "doctor" has hijacked the plane with the 3 inch scapel.
biggrin.gif
 
Jeez; I can't leave you guys alone for a minute!

You do the Heimlich maneuver, or whack him between the shoulder blades. AFTER you have determine that he does in fact, have an obstructed airway. If a person can talk, he is NOT obstructed.

The next thing I would do is try to visualize the foreign object and see if I could grab it and pull it out. People frequently choke on large pieces of poorly masticated food. This, BTW is not official Heart Assn. doctrine, but makes sense to me.

Only then would I do a crycothyrotomy. This is where you go through the crycothyroid membrane (the little depression just below your Adam's apple), making a small incision, then putting something like a soda straw or a metal ball point pen bbl. into the incision to keep it open.

This is NOT a tracheostomy. A tracheostomy is done lower down on the trachea, and the presence of the thyroid, which bleeds like stink, in this area mitigates against doing this proceedure in an emergency field situation.

BTW, if they have scalpels in the airplane first aid kit, it is news to me. They don't even have antihistamines, as far as I can recall.

I would use my keychain Buck Titanium slip lock folder for the crycothyrotomy, BTW. I do carry a Parker T-ball Jotter in Stainless Steel just so I would have something to poke down the guy's incision also. Well, actually I more commonly use it to write checks, but it is always there.

Walter Welch MD, Diplomate, American Board of Emergency Medicine. yada yada yada
 
Ad Nauseam Hypotheticals are BS.
I.E. "What if...". Like a little kid asking "why?" over and over to each answer .
As an adult it becomes "Ask Sh.t questions, get sh.t answers."
This is not a flame.
smile.gif


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Regards,
Gester

AKTI Member #A000190

It's easier to get forgiveness than permission.



[This message has been edited by gester (edited 16 October 1999).]
 
The advanced first aide kits got a major upgrade about a year ago. And now, they're starting to get AEDs (automatic external defib) on a lot of planes too.

I don't know the exact packing list, but I suspect the scapel is either a #11 or a #21 (those are the most general-purpose blades) and both are about 1" of edge. In fact, you could probably carry a plastic-handled #11 or #21 through the metal detector without setting it off. There's less metal in a #11 scapel blade than in a single dime.

Several years ago I was on a flight non-stop from Seattle, WA to Nashville, TN. I flew that route many times. It was a great flight. Left SEA at 11:59pm (no planes ever leave or arrive at midnight or noon, you know, always 11:59 or 12:01), and arrived into BNA at about 8:00am (you gain two hours, keep in mind). So, basically, you get a good night's sleep and wake up in the Music City. But, on this flight, we were disturbed when the loudspeaker asked if there was a doctor aboard. The lady in the seat in front of me got up and went forward. Moments later, she returned, fished around in here carry-on and removed a little black bag. A few minutes later, they announced we'd be landing in Laramie (SP?), Wy to discharge a seriously ill passenger.



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Chuck
Balisongs -- because it don't mean a thing if it ain't got that swing!
http://www.4cs.net/~gollnick
 
I can't help thinking of that episode of MASH when Father Mulcahey performed a tracheostomy with a pen knife and an eye dropper. Always my favorite reason to give when someone asks why I carry a knife.

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James Segura
San Francisco, CA


 
Walt, I think you're right about the first aid kits on airlines.

The Victorinox website has a link for testimonials and mentioned a doc doing a trach during flight using a SAK when they discovered the kit lacked a knife.
 
Alright, guys, I need to step in on this one...when someone is choking, you NEVER, EVER, under ANY circumstances, deliver the classic whack on the back. At best this is a useless, time-wasting step, and at wort it serves to dislodge the food and cause it to fall further into the airway. This is a bad thing. If it goes to the lung, then it's really bad because the patient will stop coughing and everyone will think the olive shot out of his mouth when, in fact, it is simply lodged in an airway where there are no cough centers for the brain. Ever heard of an infection? Here's a great recipe!
That said, almost all the time the food will be dislodged using the Heimlich, bioth in the classic position as well as in the supine position. If that fails, a tracheotomy only works when the food is lodged ABOVE the area being cut. That, sorry to burst anyone's bublle, translates to almost never. The tracheotomy is a TV classic, but, alas, in real life it is not very useful. SOrry!

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Madpoet (Mel Sorg, Jr.) Tribute page:
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Sorry Chiro, but I gotta disagree with you on that one.
Remember Infant CPR?
Ya whack the little fella on the back 3 times.
smile.gif

As for the knife..... well, I'm in a crabby mood this morning, so I'll say The KGB Ballistic Knife.
(If you're in the first row and the victim's in the 30th, you don't even have to get outta your seat!)
Amen't I helpful?
smile.gif


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Vampire Gerbil: similar to a domestic gerbil, except for the odd accent and little black cape.

 
I stand by my post. Rapid depressurization of the cabin is the ONLY way to go.
wink.gif


In all seriousness Chiro75 is right. You keep doing the heimlich manuever until the object dislodges, you obtain at least a partial airway, you get help from a higher medical authority, or rigor mortis sets in
frown.gif
Back blows are never used on adults and children (as per American Heart Association guidelines for professional rescuers).

As soon as you try and cut into somebody any protection from good samaritan laws goes away (unless of course you are trained to do this). I hope the doctor asking for the knife isn't a dermatologist.....
redface.gif


Still a fun thread...


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-j-

How do I set my laser printer to stun?
 
Good one VG! HaHa! Not such a dumb one gester. I keep my killer Micra scalpel sharp and don't use it. Never know when emergency surgery is needed, such as a collapsed trachea.

jeff
 
I would pull out a Crocodile Dundee type knife and hopefully the victim will be so shocked that he/she will violently cough up said olive. Or the corkscrew on a swiss army knife might be able to get enough of a bite on the olive to pull it out. If it happened in real life, I would probably freak out and not think of these wonderful ideas I've had while in the comfort of my pajamas.

Also, the knife would have to be carbon so I could smuggle it on the plane. By the time I thought all of this up, the guy would have choked to death. Eh, what are ya gonna do?

[This message has been edited by Burnout (edited 16 October 1999).]
 
Emergency Dept. physicians, of which I am one, frequently deviate from the hallowed recommendations of the AHA.

This is not because we are deviates (well, most of us aren't), but because we are considered the best acquainted with the newest techniques in resuscitation. In fact, we are exempt from the requirement to take BCLS and ACLS (although I always took the courses anyway).

I would still try the back blows. However, I should state that this is just my opinion. It gives you something to do between the time the Heimlich fails, and the patient becomes comatose enough to not resist the cricothyrotomy.

Walter Welch MD, Diplomate, American Board of Emergency Medicine.
 
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