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학습 자료 둘러보기 →| Option | Why It Is Incorrect for This Specific Scenario |
|---|---|
| 1. Perform abdominal thrusts | Abdominal thrusts (the Heimlich maneuver) are indicated for a complete airway obstruction where the child is unconscious or cannot cough, speak, or breathe. This child is conscious and wheezing, which indicates a partial obstruction with some air movement. Performing thrusts on a partially obstructed, conscious child can cause the object to shift and create a complete, fatal obstruction. It also risks visceral injury. |
| 3. Encourage forceful coughing | While encouraging a cough is appropriate for a partial obstruction in an older, cooperative child or adult, it is not a reliable or safe primary intervention for a 2-year-old toddler in acute distress. A toddler cannot follow complex directions to produce an effective, coordinated cough. The risk of the foreign body dislodging and moving from a partial to a complete airway obstruction during uncontrolled coughing is significant. Definitive removal via bronchoscopy is required . |
| 4. Place supine and deliver back blows/chest thrusts | This sequence of back blows and chest thrusts is the recommended basic life support protocol for an infant under 1 year of age with a complete or severely compromised airway obstruction. This patient is a 2-year-old toddler, placing them outside the infant algorithm. Furthermore, like abdominal thrusts, this maneuver is for a child who has become unresponsive or has a completely ineffective cough, not a conscious patient with a partially patent airway. |
The priority for a conscious child with a partial airway obstruction (audible wheezing, effective air exchange) is to avoid basic life support maneuvers like abdominal thrusts or back blows. These interventions are reserved for complete obstructions and can risk dislodging the object, converting a partial block into a fatal complete one.
The definitive treatment is emergency rigid bronchoscopy. The nurse's immediate role is to keep the child calm and in a position of comfort, often sitting upright, to minimize oxygen consumption and agitation. Simultaneously, prepare the emergency equipment and the bronchoscopy team.
Never force the child to cough or attempt a blind finger sweep. Any intervention that agitates the child can lead to laryngospasm or movement of the foreign body, causing a complete airway obstruction. Continuous monitoring of respiratory status and oxygen saturation is critical.
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