Relief of Choking
A foreign-body airway obstruction can kill within minutes, but the response depends on whether the obstruction is mild or severe and whether the victim is responsive. The BLS exam expects you to distinguish these situations and act correctly for adults, children, and infants.
Mild versus severe obstruction
With a mild (partial) obstruction, the victim can still cough forcefully, speak, or breathe — stand by, encourage continued coughing, and do not interfere, because a strong cough is more effective than any maneuver. A severe obstruction is signaled by a silent cough, inability to speak or breathe, high-pitched or no sound, cyanosis, and often the universal choking sign (hands clutching the throat). Severe obstruction demands immediate action.
Maneuvers by age and responsiveness
For a responsive adult or child with severe obstruction, give abdominal thrusts (the Heimlich maneuver) until the object is expelled or the victim becomes unresponsive; for a pregnant or obese victim use chest thrusts. For a responsive infant, deliver cycles of 5 back slaps followed by 5 chest thrusts — never abdominal thrusts, which can injure abdominal organs. If a choking victim becomes unresponsive, lower them to the ground, activate emergency response, and begin CPR starting with compressions. Each time you open the airway to give breaths, look in the mouth and remove an object only if you can see it — never perform a blind finger sweep.