5.0 First Aid Protocol for Choking (Foreign Body Airway Obstruction)

Responding to a choking victim requires a rapid assessment to determine the severity of the blockage. The correct intervention depends on whether the airway is partially or completely obstructed.

5.2.1. For Partial Obstruction

• First, assess if the person can speak, cough, or breathe.
• If they can make sounds and are actively coughing, the primary instruction is to encourage the person to keep coughing. The body’s natural coughing mechanism is the most effective way to clear a partial blockage.
• You should not hit the person on the back. This action could inadvertently cause the object to shift and become more deeply lodged, turning a partial obstruction into a complete one.

5.2.2. For Complete Obstruction

• Act immediately if the person cannot breathe, speak, or cough. Other signs include making high-pitched noises, clutching the throat, and turning blue.
• In this case, the Heimlich Maneuver (Back Blows and Abdominal Thrusts) is the required intervention to dislodge the object.

5.3.1. On Adults and Children (Over 1 Year)

1. Stand behind the person. For a child, you may need to kneel.
2. Lean the person forward and deliver 5 firm back blows between their shoulder blades with the heel of your hand.
3. After the back blows, wrap your arms around their waist.
4. Make a fist with one hand. Place the thumb side of your fist against the person’s abdomen, just above the navel and well below the ribcage. Grasp your fist firmly with your other hand.
5. Deliver 5 inward and upward abdominal thrusts.
6. Continue the cycle of 5 back blows followed by 5 abdominal thrusts until the object is expelled or the person becomes unconscious.
7. If the person becomes unconscious, carefully lower them to the ground. Immediately call for emergency services and begin CPR, starting with chest compressions. Before giving rescue breaths, look inside the mouth for the object and remove it only if it is visible.

5.3.2. On Infants (Under 1 Year)

1. Lay the infant face-down along your forearm, supporting their head and jaw with your hand. Ensure the infant’s head is lower than their body.
2. Deliver 5 firm back blows between the infant’s shoulder blades with the heel of your hand.
3. Carefully turn the infant over, face-up, onto your other forearm, keeping their head lower than their body.
4. Deliver 5 chest thrusts in the center of the chest (on the lower half of the breastbone) using two fingers.
5. Continue the cycle of 5 back blows and 5 chest thrusts until the object is expelled or the infant becomes unconscious.
6. If the infant becomes unconscious, call for emergency services immediately and begin infant CPR.

5.3.3. Special Cases: Pregnant or Obese Individuals and Self-Rescue

• For Pregnant or Obese Victims: Abdominal thrusts are not safe or effective. Instead, you must perform chest thrusts. Place your fist in the center of the person’s breastbone and deliver firm thrusts in the same manner as abdominal thrusts.
• For Self-Rescue: If you are alone and choking, make a fist and press it into your own abdomen. Use a hard surface, like the back of a chair or a countertop, to drive your fist inward and upward to create a forceful thrust.

While knowing how to react in an emergency is vital, proactive safety measures are the best way to avoid these situations entirely.