Clearing an obstructed airway in a conscious adult or older child
- Determine if the person can speak or cough. Ask the person to speak. Ask the person if they are choking. If the person cannot speak and if the person is choking, tell the person that you will help them and proceed to the next step.
- Abdominal thrust (Heimlich maneuver): Stand behind the person. Make a fist with one hand just above the belly button. Cover the fist with your other hand. Perform an abdominal thrust (Heimlich maneuver) inward and upward repeatedly until the foreign body is expelled or until the person becomes unresponsive. A chest thrust may be used for markedly obese persons, late stages of pregnancy or persons with recent abdominal surgery.
- If the adult or older child becomes unresponsive, lower the person to the floor. If you are alone, call 9-1-1 first. If you are with someone, have that person call 9-1-1. Begin 30 Chest Compression, Look in the mouth for any foreign object; remove it only if seen. DO NOT perform a "blind finger sweep." Attempt a rescue breath, if there is no chest rise, reposition the airway and attempt another breath again. If still no chest rise repeat sequence of 30 compressions, look in the mouth for object, and attempt of breaths. Continue the sequence until chest rises, or person begins breathing.
Continue care until help arrives
If you remove the object from the mouth, proceed with two rescue breaths. This is to help re-oxygenate the person. If the chest rises, then check the carotid pulse closest to you. If no pulse, begin adult CPR. If there is a pulse but no breathing continue rescue breathing at the rate of 1 breath every 5-6 seconds and reassess every 2 minutes as long as pulse is present.