Earning a first aid card through the Michigan Construction Trades Safety Institute's Save-A-Life program brings obvious benefits to your job in the skilled trades. Yet medical emergencies can arise anywhere, striking anyone. It especially hits home when the life of a family member is endangered.

Just ask April Nolan, who, with her husband Scott, received the training when she was on the staff of Operating Engineers Local 324. During her cardio-pulmonary resuscitation (CPR) class she asked her instructor several questions about the differences in the techniques used for adults and for small children. "He happened to have a doll with him," April says, "and he covered a portion of infant CPR."

Earlier this summer April prepared her home for a bridal shower for her sister-in-law. Visiting were her husband's mother and father, as well as two of his brothers. All were pitching in to make sure everything was well organized for the celebration. Even Morgan, April's 2-1/2 year old daughter, did her part.

"It was about 9 p.m. and I had asked my daughter to stay in the kitchen with her grandma because she was letting the mosquitoes into the house," April says. "I was in the garage, talking to Morgan and my mother-in-law when after a couple of minutes there was silence."

A mother's instinct may have directed April to turn around. She discovered that her child was beginning to suffocate. The little girl had been given a hard piece of candy and had accidentally inhaled it.

"When I turned around, I yelled at my mother-in-law: 'She's not breathing! Call 911,'" April says. She grabbed Morgan, who was still standing, while her mother-in-law called the 911 dispatcher. April attempted the Heimlich maneuver on the little girl. It didn't work. She called to her husband, who was out in the back yard, and he ran to her aid.

"The dispatcher said, 'If she's breathing at all, stop,'" April says. "So I laid her on my lap to re-evaluate her condition and she began to turn blue. Scott grabbed her from me and began working on her. After several attempts and two hard blows on the back, she began to throw up."

Despite the emotional circumstances, and instead of panicking, the first aid and CPR instruction April and Scott received helped them to make the quick, rational decisions needed to save their daughter's life.

"If it wasn't for the training, who knows what would have happened," April says. "Thank God. The emergency vehicles arrived and assessed the situation. My daughter's doing fine."

Choking caused by a foreign object obstructing a body airway accounts for about 3,000 deaths in the U.S. each year. You may not think it would happen very often on a construction site, but the piece of hard candy inhaled by Morgan could just as easily be the mistakenly gulped breath mint that went down the "wrong tube" of a pipe fitter, painter, or sheet metal worker.

The following is not a step-by-step guide. It's presented to inform you of the training you should have to save an adult or child above the age of eight from choking to death.

If the victim is having a problem but can still speak, cough, or breathe, don't interfere. Just stand by to make sure the situation clears itself and improves. But if the victim can't speak, cough, or breathe, the Heimlich maneuver should be used. At the same time, have someone call 911 for help from emergency medical personnel.

The Heimlich maneuver consists of a series of subdiaphragmatic abdominal thrusts. You've probably seen it performed on television - including comedy skits - but that alone won't make you an expert in it. And when someone is turning blue in your hands, you'll want to do it correctly.

If the maneuver is at first unsuccessful, and the victim becomes unconscious, position them on their back with their arms by their sides. Do a tongue-jaw lift and finger sweep their mouths to remove any foreign objects. Tilt the head back and lift the chin, then attempt rescue breathing. If that's not working, perform six to ten Heimlich maneuvers. Repeat this until successful. If the obstruction is expelled, be prepared to perform CPR if necessary.

By all means, be persistent. Continue until success is achieved or advanced life support help arrives and can take over.

Children between the ages of one to eight - and infants below the age of one - require special measures. All of these steps are best learned in a class taught by an experienced instructor, such as those provided by the MCTSI.

To get you and your fellow workers involved in Save-A-Life certification, have your employer or union contact the MCTSI directly, to set up classes and obtain schedules. It can be reached at (800) 657-8345 or by e-mail at info@mctsi.org.