m. Continue Efforts to Expel Obstruction. If the chest thrusts did not expel
the object, continue your efforts until the object is expelled or you are ordered to stop by
a medical authority. If possible, evacuate the casualty as you continue your efforts.
(1) Open the infant's mouth using a tongue-jaw lift technique and remove
any visible foreign matter with a finger sweep.
(2) Open the infant's airway and check for signs of breathing. If
spontaneous breathing occurs, maintain the airway.
(3) If the infant does not resume breathing on his own, administer two
ventilations using the mouth-to-mouth-and-nose method.
(a) If your ventilations were successful, check the infant's pulse. If a
pulse is absent, administer CPR (paragraph 6-6). If a pulse is present, administer
rescue breathing at the rate of one ventilation every 3 seconds and recheck the pulse
again every few minutes.
(b) If your ventilations were not successful (air did not go in and chest
did not rise), continue with your efforts to expel the obstruction.
(4) If your ventilations were not successful, position the infant for backblows
and administer five back blows.
(5) If the backblows did not expel the obstruction, position the infant for
chest thrusts and administer five chest thrusts.
(6) If the chest thrusts did not expel the obstruction, continue with your
efforts to expel the obstruction [paragraph 7-4m(1) through (6)].
Public education is vital to alleviate fear of risk of disease transmission during
CPR. Use barriers as recommended by the Centers for Disease Control and
the Occupational Safety and Health Administration.