Choking (Adult)

In a choking emergency it is vital to determine whether the victim is moving any air in and out of the lungs: in a total airway obstruction the victim will quickly collapse and die from lack of oxygen and air unless emergency measures are taken; in a partial airway obstruction some air movement continues through the narrowed windpipe and there is time to get medical attention before collapse is likely.

The victim may complain of:

• Breathing difficulties (shortness of breath)

• Difficulty in speaking

Look for:

• Noisy breathing, wheezing or high-pitched ‘crowing’ noise

• Distress

• Inability to speak

• Congested face skin with blueness of the lips

• Throat-clutching or pointing to the throat

• Later, collapse and unconsciousness

What you should do:

*If the victim is still able to breathe, speak, cry or cough (partial airway obstruction).

• The victim will be conscious but distress with the struggle to breathe. Be reassuring and encourage her to cough or breathe through her nose. She may stand up to breathe, using a chair or table for support. DO NOT thump her on the back – this may make the foreign object go further down the airway.

• If the victim recovers quickly, allow time for the throat to relax before offering a soothing drink. Often the victim will not want to eat or drink for a while.

• If the breathing becomes noisy, call for an ambulance to take the victim to hospital for emergency treatment.

*If the victim is unable to breathe, speak, cry or cough (total airway obstruction).

• The victim will rapidly lose consciousness. He should be eased to the ground and laid on one side, to keep the airway clear and open.

• Give victim up to four sharp blows between the shoulder blades, using the heel of your hand, in an attempt to loosen or shift the foreign object blocking the airway.

• If the victim still cannot breathe, give up to four chest thrusts. Kneeling beside him, put one hand on one side of the chest, close to the armpit. Put your second hand beside the first. With straight arms, give up to four quick downward thrusts in an attempt to move air from the lungs and up the airway to move the foreign object.

• If there is still no improvement, check the airway to make sure that it is clear. If any foreign object is seen or felt at the back of the throat, remove it immediately. Open the airway as far as possible by tilting the victim’s head back and supporting the lower jaw in a forward position.

• Check again for any signs of breathing: look and feel with your hand for movement of the lower chest or upper abdomen, and listen for air escaping from the mouth or nose. If the victim is still not breathing, turn him on his back and begin expired air resuscitation, attempting to blow air past the obstruction and clear the airway.

Important Note:

• Shout for help, or if no help is around, call for an ambulance. Keep giving expired air resuscitation at once and continue until trained help arrives.