Failures in Parenting: Cherub tomatoes and the heimlich manuever

NatureSweetMy little J is too curious for her own good. She needs to be ever so closely supervised because if there is danger nearby, she will find it and fast. This was the case two Wednesdays ago when Mommy needed to go to the rest room and then start on dinner. When I came back into the kitchen, I noticed that J was being very secretive over at the coffee table. I walked over and saw that she had taken a whole tub of Nature Sweet Cherub tomatoes out of the fridge and had put them in her teacups. I scolded her for going into the fridge for about the millionth time, returned the tomatoes to their container and put them back in the fridge.

J was chewing on a tomato when I walked back into the kitchen (all of 5 ft away) and this did not alarm me. Although I would normally cut them in half had I served them to her, she had been snatching whole ones off our plates just last weekend and had handled it just fine. I was not concerned in the least bit. In fact, I may have been lamenting how grown up our little girl was becoming.

Just then, J spat tomatoes all over the coffee table. I rushed over and saw that she was choking. In typical toddler fashion, she must have shoved more than one tomato in her mouth when she heard me coming and I had not noticed. Now she was clearly choking on a tomato and this momma was panicked.

I should preface this by saying that I am a Physical Therapist by trade and get my healthcare provider CPR renewed every other year. I have print outs of the infant first aid for choking in our nanny binder and have a good handle on the adult version. But in that moment of panic, I could not pull it together.  I could not remember at what age you switch from the back blows/chest thrust to the heimlich. Was it age 1? 2? The answer should have been clear as day since my daughter is 2 1/2. But I began by leaning her towards the coffee table and delivering 5 back blows. That did not clear her of the obstruction. I flipped her back around and gave her 5 chest thrusts. With 2 fingers around the nipple line as for an infant. This had no effect as it is completely wrong! And I suspected as much but I was just so distraught. What kind of healthcare worker am I?

I was just about to race my choking child out to the curb where I had seen some neighbors gathered. Surely someone more calm and competent was out there. That is when I saw the tomato and did the unthinkable. I stuck my fingers in my daughter’s mouth and yanked that tomato out. She began crying and spat out some blood because I had scratched the back of her throat with my finger nails. This was also a wrong, wrong thing to do, although (thank you Jesus) it worked in my case. I knew you were not suppose to finger sweep haphazardly (and certainly just with your pinky not multiple fingers) but I couldn’t exactly remember why. Was it that she might bite me? I’d gladly lose a finger for my J. But the real reason is that you can push the object down the throat further making it very difficult to clear the obstruction. Finger sweeping comes into play more with an unconscious victim and then you use your pinky to sweep the object to the front of the mouth where you can remove it.

This is what I should have done:

1) GIVE 5 BACK BLOWS: Kneel behind child. Lean child forward across one arm while delivering 5 back blows between the shoulder blades with the other.

2) GIVE 5 ABDOMINAL THRUSTS: Remain kneeling behind the child and place fist with thumb side against abdomen just above belly button. Cover fist with other hand and give 5 quick upward thrusts.

3) Continue cycles of 5 back blows/5 abdominal thrusts until obstruction is cleared or child becomes unconscious (then you add rescue breaths and CPR if it becomes necessary).


What I have done since:

I typically pride myself on being prepared. I have an extensive binder for our nanny with a first aid section in it but had not updated the choking/CRP pictures upon J turning 1. I printed this Red Cross ready reference and made a copy for our binder as well as one to hang up in the medicine cabinet. Although I have taken CPR/First Aid a gazillion times and probably could deliver it to your child or any adult, I was not clear minded with my own child.  I think this may be the case with others as well.  The best defense is to have the instructions where they can be quickly accessed so no thinking is necessary.  The Red Cross also has a first aid app, which I downloaded to my iPhone should an emergency rise when I am on the go.

Contrary to the title of this post, this was not truly a failure in parenting as my child is alive and well. I did save her and her only real repercussion was a sore throat. Nothing a popsicle couldn’t fix. But I did have a failure of reason and logic. This is the very definition of panic. And it could have ended very badly. I hope you will learn from my mistake and take a few moments to brush up on your First Aid skills. You never know when you might need them.