5.1 Adult Choking

Choking is a life-threatening emergency that occurs when the airway becomes blocked by food, a foreign object, or even the tongue. The obstruction can be partial (allowing some airflow) or complete (no airflow), and rapid intervention is essential to prevent loss of consciousness, brain damage, or death.

Adult Airway Obstruction

Recognizing the signs of choking is the first step in saving a life. An adult who is choking may display the following:

• Silent struggle to breathe: Unable to speak, cough, or make sounds.
• Clutching the throat:
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  Clutching the throat:

  

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  A universal distress signal for choking.
• Cyanosis: Bluish skin, lips, or fingernails due to lack of oxygen.
• Panicked behavior or loss of consciousness: As oxygen deprivation worsens.

Responsive Adult – Severe Airway Obstruction

If the adult is conscious but unable to breathe, speak, or cough effectively:

1. Ask: “Are you choking?” and get consent to help.
2. Stand behind the person and deliver abdominal thrusts (Heimlich maneuver):
   • Place your fist just above the navel (belly button).
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     above the navel (belly button).

     

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   • Grasp your fist with your other hand.
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     Grasp your fist with your other hand.

     

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   • Deliver quick, upward thrusts
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     Deliver quick, upward thrusts

     

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     until the object is expelled or the person becomes unresponsive.

Note: Some international guidelines may teach back blows for adult choking. However, U.S. guidelines (AHA and Red Cross) recommend abdominal thrusts only for adults and children over 1 year old.

Unresponsive Adult – Begin CPR

If the person becomes unresponsive:

1. Lower them to the ground and activate emergency response (911 or EMS).
2. Begin CPR immediately, starting with chest compressions.
3. After each set of compressions, open the airway and look in the mouth. If you see the object, carefully remove it.
4. Do not perform a blind finger sweep. Only remove visible obstructions.

Continue CPR until the object is dislodged, the person begins to breathe, or emergency help arrives.