Choking and Airway Obstruction

When & Why?

Respond to foreign-body airway obstruction before it causes respiratory or cardiac arrest.
Mild Obstruction:

• Patient can cough effectively and move air.
• Encourage coughing and monitor closely.
  Severe Obstruction:
• Weak or absent cough.
• Unable to speak or breathe effectively.
• Little or no airflow.
• May become cyanotic or unresponsive.

Before You Start

• Ensure scene safety.
• Determine whether the patient can cough or speak.
• Summon assistance and activate emergency response for severe obstruction.
• Follow the patient’s emergency orders and facility protocol.

Steps

Responsive Adult — Severe Airway Obstruction

1. Activate the emergency response system and summon assistance.
2. Deliver 5 back blows using the trained technique.
3. Deliver 5 abdominal thrusts.
4. Repeat alternating cycles until the object is expelled or the person becomes unresponsive.
5. If the obstruction clears, continue monitoring until appropriate medical personnel arrive.

Special Circumstances: For adults in late pregnancy or when the rescuer cannot encircle the abdomen, use 5 chest thrusts instead of abdominal thrusts, alternating with 5 back blows.

If the Resident Becomes Unresponsive

1. Activate emergency response if not already done.
2. Begin CPR, starting with chest compressions, according to current BLS training.
3. When opening the airway to provide breaths, look for a visible foreign object.
4. Remove the object only if clearly visible and safely reachable.
5. Never perform blind finger sweeps.
6. Continue CPR according to current training until advanced care takes over or the resident recovers.

Follow the resident’s documented emergency care orders and facility protocol.

Safety & Observations

• Do not interfere with effective coughing.
• Never perform blind finger sweeps.
• Do not give food or drink to clear an obstruction.
• Monitor breathing and responsiveness.
• Follow the patient’s documented emergency care orders.

What Should I Remember?

• Mild: Encourage coughing.
• Severe: Activate help and intervene.
• Unresponsive: Start CPR.
• Practice using current BLS/first-aid training.

Related

• Cardiac Arrest & CPR Response
• Recognizing Patient Distress
• Emergency Preparedness & Response

Practice

• Studied
• Observed
• Practiced
• Passed checkoff

Sources

• CNA Module 12 — Airway Obstruction
• AHA — Adult Basic Life Support
• AHA — 2025 Adult Foreign-Body Airway Obstruction Algorithm

Flashcards

What indicates severe rather than mild choking?03-application / clinical-skills

Answer

Inability to cough effectively, speak, or breathe.

What should you do if a choking person can cough effectively?03-application / clinical-skills

Answer

Encourage coughing and monitor.

What must not be done for airway obstruction?03-application / clinical-skills

Answer

Blind finger sweeps.

What should you do if a severely choking adult becomes unresponsive?03-application / clinical-skills

Answer

Begin CPR with chest compressions; check for a visible object before breaths.