18 Jul Baby who swallowed pistachio nutshell while crawling died ‘after paramedics did not attempt to remove it from his airway’
A seven-month-old baby died after choking to death on a pistachio nutshell! Paramedics did not remove the shell from the baby’s throat, an inquest heard.
Little Gauravdeep had been crawling on the living room floor when he picked up the shell and put it into his mouth. The nut shell began to choke him and his mother immediately called for an ambulance as her son struggled for breath. The family tried to perform CPR on the baby until the ambulance arrived.
When paramedics turned up after three minutes, they allegedly did not attempt to remove the shell which was lodged in the child’s throat, a Coroner’s Court heard. Basically, they did not do a ‘Finger Sweep’ to retrieve the shell or attempt to give the baby back slaps or abdominal thrusts which would be the correct thing to do. Experts requested from the Ambulance Service, whether crews were trained to carry out treatment procedures for the choking victim. The case was not concluded until a later date until investigations were over. The Ambulance Service could not comment on the fatality until it was known whether the crew had been educated to learn the skill and have the equipment available to perform a Tracheostomy (an opening surgically created through the neck into the trachea (windpipe) to allow direct access to the breathing tube). If they hadn’t, all they could have done were basic choking protocols i.e. Scoop and Run.
A Tracheostomy is a difficult procedure, even for a surgeon to perform in a hospital operating theatre and in a moving ambulance, almost impossible. Ambulance crew are actually forbidden to attempt this difficult procedure. Equally, by trying to retrieve a foreign object from the throat, it can be pushed further down the airway making the release virtually impossible. Chest compressions are the best option, with the possibility that the blockage be blown out, that said to do this successfully on a baby is extremely difficult.
The New American Heart Foundation rules state that you should not blindly sweep or feel around a patient’s mouth for an object as you are more likely to push it further down and a paramedic is also not trained in Tracheostomies. Paramedics in the UK are required to have a 2-3 year Para Medicine degree and are trained to a very high standard. This tragedy is in my opinion, pretty shocking and sad.
I am sure you can imagine that trying to perform an emergency Tracheotomy on little baby in a fast moving ambulance is not an easy task, whether they are experienced paramedics or not. ‘Scoop and Run’ was probably the best idea at the time, in my opinion, given the circumstances and the distance from the hospital, because Guaravdeep was already in Respiratory Arrest. Paramedics have only seconds to decide what to do in an emergency situation, especially involving babies and children. I always say to my students that ‘no two people are the same and no two emergency situations are the same’. Everyone and everything is unique.
These days there is a shortage of Ambulance Service people and the UK is currently employing new people from abroad to do this very difficult and stressful job. I could never imagine getting used to a child dying, because I failed to save them!
My conclusion is that it is the parents who need to learn First Aid. The best one is a One Day Person Appointed First Aid course and you should enrol as soon as possible so you that you can save your own child’s life and not rely on someone else.