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  1. Conscious Adult Choking

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Show full transcript for Conscious Adult Choking video

This conscious adult choking lesson is for situations where you can see that an adult is choking and he or she is conscious. The choking victim will usually be exhibiting some unmistakable signs, including:

  • They cannot cough
  • They cannot breathe
  • They cannot speak

Another sign to look for is the universal sign for choking – when the victim places both of their hands around their throat.

The good news is that, even when dealing with a full obstruction, in most situations the obstruction will come out if you perform the abdominal thrusts correctly.

Pro Tip #1: Only worry about calling 911 and activating EMS if doing so is quick and easy, or there is another person nearby that can call. Otherwise, don't waste time calling 911 and go right into assessing the victim.

How to Provide Care

The first thing you want to do is face the person and look them in the eyes. You want confirmation that the victim is choking, and you want to receive permission to help the person.

"Are you choking?"

The person will probably nod yes.

"May I help you?"

You'll likely get another nod. If the victim is conscious, it's always a good idea to get permission and it only takes a second.

Abdominal Thrust Technique for Adults

  • Elevate the victim's arms and elbows so you have clear access to the abdominal area.
  • Locate the belly button using the index finger on your dominant hand and hold it there. This is the landmark you'll use to find the correct abdominal point.
  • On your non-dominant hand, tuck in your thumb and place your fist thumb-first above the finger that's on the belly button, essentially stacking one on top of the other vertically.

Pro Tip #2: Make sure you stay below the xyphoid process and above the belly button. This is the diaphragmatic region where you'll be performing the abdominal thrusts.

  • Take your index finger off the belly button and wrap that dominant hand over your other hand that's positioned on the victim's diaphragm.
  • Keep your elbows out so they're resting on the victim's ribs as little as possible.
  • Thrust up and in and turn your hands upward as you perform each thrust.
  • Perform the abdominal thrusts until the object comes out or the person becomes unresponsive.

Pro Tip #3: It's important to turn your hands upward as you perform each thrust, as this will bring the diaphragm up and in and compress the lower lobes of the lungs, forcing air to shoot up the trachea and pop the obstruction out. This works in the majority of choking situations.

  • Once the object comes out, the victim will begin coughing to help clear the airway and should begin breathing normally again in a matter of seconds.
  • Encourage the victim and let the person know that he or she is OK now and have them sit down if necessary.

If you called 911, let them come anyway, so the person can be examined. EMS responders can check the choking victim's airway and listen to their lungs to make certain that there are no partial obstructions remaining. And they can do a quick assessment for internal bleeding or other damage.

If you did not call 911, it's always a good idea to encourage the choking victim to see his or her own doctor to make sure everything is OK.

If you weren't able to remove the obstruction using the abdominal thrust technique, the victim will go unconscious pretty quickly. Help lower them to the ground, so they don't fall and injure themselves. Call 911 immediately and activate EMS or call in a code if in a healthcare setting. Then begin performing the unconscious adult choking procedure.

Special Consideration for Pregnant Women

It's important to remember that when treating a pregnant woman, regardless of the situation, you're actually treating two patients. Saving mom is always the priority, as saving mom will also save the baby. So, be just as aggressive in your treatment.

However, you don't want to injure the baby while performing the abdominal thrusts. Which is why you'll be using a different area for the thrusts – directly under the breasts and on top of the sternum.

Pro Tip #4: Besides the point of thrusting, there is only one other difference when dealing with an adult choking victim who's pregnant. The thrusts will be inward only; not up and in.

A Word About Types of Airway Obstruction

There are two types of airway obstructions – anatomical and mechanical, also referred to as Foreign Body Airway Obstruction (FBAO).

Anatomical obstructions occur when a part of the victim's anatomy is causing the blocked airway. It could be due to the tongue, swollen mouth tissues, or a swollen throat.

The tongue is the most common type of anatomical obstruction, as it relaxes in unconscious victims when their bodies are deprived of oxygen. Because the tongue tends to relax on the back of the throat in these situations, it can block airflow to the lungs.

Mechanical or FBAO obstructions include food, toys, and liquids. Poorly chewed food is the biggest culprit – eating too fast and/or laughing, talking, or running while eating can contribute to choking. And with small children, it's no surprise that toys are also a common choking obstruction.