Instructors should be CPR certified. Even without chokes, Taekwondo is a strenuous physical activity that carries some risks for which the instructor should be prepared.
Immediately release the victim and lay him or her flat so that blood may flow naturally back to the brain. Placing the victim on his or her side, with the head resting on the arm, will prevent vomit aspiration and facilitate breathing. Monitor the victim closely to make sure the airway is open and the victim is breathing. The victim will generally regain consciousness spontaneously and be unharmed. If the athlete does not regain consciousness in 20 to 30 seconds and remains unresponsive to your efforts to revive him or her, medical assistance should be sought immediately.
Try to awaken the patient with vocal or physical stimuli such as tapping, triceps pinch, or shouting. Check for breathing by putting your face close to the patient's mouth and looking at the chest, listening for air exchange, and feeling for a breath. Keep the airway open and initiate rescue breathing if there is no breathing. If a pulse is absent, commence chest compressions.
There are many old methods of traditional resuscitation that can also assist the victim in recovery; however, if the outcome is less than desirable, these interventions may not be defensible in courts. Although CPR is commonly recognized as the appropriate response to a medical emergency, the traditional forms of resuscitation may be useful in special circumstances.
Traditional resuscitation techniques
- The direct massage of the carotid triangle on the neck to open up a collapsed artery or to stimulate the carotid sinus manually.
- Methods of assisting the victim in waking up and focusing attention, such as slapping the victim, striking the sole of the foot, or yelling.
- Methods of inducing or simulating breathing through massage of the chest or diaphragm by expanding and contracting the lungs.
- With the victim sitting before you, from behind, bend your right knee and place the kneecap against the person's spine. Spread your fingers and place your hands on his or her lower chest, hooking your fingers under the lower ribs. Pull back as if opening the ribs to either side, put your weight on the shoulders to bend the body back, and press with your right knee. This will draw air into the lungs. When the ribs have opened as far as they will go, release them. Air will be exhaled from the lungs. Repeat the process slowly and regularly.
- Kneel to the right of the victim and support his or her upper body with your left arm around the shoulder. Put the palm of your right hand on the abdomen, just above the navel, and press up against the solar plexus or pit of the stomach. This will cause the diaphragm to rise, expelling air from the lungs. Reinforce the action by bending the upper body forward with your left arm. Gently release your pressure to allow air to enter the lungs. Repeat this procedure until respiration is restored.
- Lay the victim on his or her back and kneel astride the hips. Place your hands, fingers spread apart and pointing toward his or her head, on the bottom of the rib cage. Lean forward and press against the ribs to make him or her exhale, and then relax the pressure. Repeat this procedure, rocking forward and back, until the victim can breathe without assistance. Similarly this can be done with the victim on his stomach.
Koiwai, E. K. (1999). How Safe is Choking in Judo?
Ohlenkamp, Neil. (1995). Principles of Judo Choking Techniques. [Online]. Available: http://Judoinfo.com/chokes.htm [2004, December 31 ]. Used with permission.