Recognizing Severity
With a mild obstruction, the patient can cough forcefully and speak. Encourage coughing and monitor closely. With a severe obstruction, the patient cannot speak, has a weak or silent cough, shows the universal choking sign, and may become cyanotic.
Interventions
For a conscious adult with a severe obstruction, deliver abdominal thrusts until the object is expelled or the patient becomes unresponsive. For obese or pregnant patients, use chest thrusts. If the patient becomes unresponsive, lower them to the ground and begin CPR, checking the mouth for visible objects before each ventilation attempt.
Key Reminders
Do not perform blind finger sweeps. Only remove an object you can see. If you can ventilate, continue; if the chest does not rise, reposition the airway and retry. Once the airway is clear, give oxygen and transport, because abdominal thrusts can cause internal injury that needs evaluation.