Choking Adult / Child

An adult or child can choke on food or other small objects.  When you begin your assessment if the adult or child can only nod or grab their throat with no verbal communication you will need to start the foreign body airway obstruction management.

As you begin your assessment of the patient, if they are still able to breathe or speak, they do not qualify for the abdominal thrusts.

1. Position yourself behind the patient.
2. Stretching your arms around the adult/child at the waist.
3. With one of your hands make a fist, placing the thumb side on the abdomen of the patient just below the xiphoid processes and directly above the umbilicus.
4. Grasp the fist with your other hand.
5. Abdominal thrusts consist of upward quick motions into the abdomen.
6. Each abdominal thrust needs to end by allowing the abdomen to re expand.
7. Repeat thrusts until the trapped object is removed from the airway.
8. Reassess patients for injuries from choking or abdominal thrusts.
9. If the patients become unresponsive at any time during your abdominal thrusts, lower the patient carefully to the ground.
10. Assess the patient’s mouth for foreign body and start chest compressions.

*Note: if you do not see foreign body on inspection of the patient’s mouth do not perform blind finger sweeps.

Choking Infant

An infant can choke on small objects and or food particles.  When you begin your assessment, if the patient is able to cough or cry, they do not need back slaps and chest thrusts. If the infant patient is unable to cry or cough, start the back slaps and chest thrusts to remove the object they are choking on.

1. Hold the baby, placing the baby face down on your arm.
2. Keep infant’s head lower than body to use gravity to help remove foreign bodies.
3. Be sure to support the head of the infant with your hand.
4. Provider can kneel to the ground to help this process by supporting your arm with your leg.
5. Deliver five back slaps between the patient’s shoulder blades with the heel of your other hand, taking less than 5 seconds.
6. Continue to support the infant’s head and neck, rotating them to face up position in your other arm.
7. Check the mouth to see if the object is visible. If so, remove the object and proceed as indicated.
8. Keep the infant’s head below their body.
9. Place 2 fingers below the nipple line on the sternum.
10. Perform 5 chest thrusts, pushing straight down ⅓ to ½ the depth of the chest.
11. Continue to repeat the cycle of 5 black slaps and 5 chest thrust until the foreign body is dislodged or the infant becomes unresponsive.
12. Once you see the object in the mouth you can remove the object.
13.  If the patients become unresponsive at any time during your abdominal thrusts, lower the patient carefully to the ground, attempting to protect the patient from trauma.
14. Assess the patient’s mouth for foreign body and start chest compressions following current guidelines.

*Note: if you do not see foreign body on inspection of the patient’s mouth do not perform blind finger sweeps.