[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Emergencies and life support](https://durgical.com/en/nursing/areas/emergency/) › Choking: foreign-body airway obstruction # Choking: foreign-body airway obstruction - Procedure If the person is coughing hard, encourage them to cough; if they cannot speak or breathe, act now; if they lose consciousness, start CPR. Updated Nov 5, 2026 ## Key points - Strong cough or can speak: do not intervene, encourage coughing and watch. - Cannot speak, cough or breathe: adult or child over 1 year, cycles of 5 back blows and 5 abdominal thrusts. - Guidelines differ: some alternate back blows and abdominal thrusts, others use abdominal thrusts alone. - Pregnant or obese person: chest thrusts instead of abdominal thrusts. - Infant: 5 back blows and 5 chest thrusts; never abdominal thrusts. - If they lose consciousness: call for help and start CPR; look in the mouth before breaths and never do blind finger sweeps. ## What it is Choking happens when a foreign body, usually food, blocks the airway. It is common in older adults, people with dysphagia or dentures, and young children. If the obstruction is mild (strong cough, can speak), the person is encouraged to cough and watched. If it is severe (cannot speak, cough or breathe), act at once: in adults and children over 1 year, back blows and abdominal thrusts; in infants, back blows and chest thrusts. If the person loses consciousness, CPR is started. Guidelines do not always agree on the order of the manoeuvres: follow the one your institution teaches. ## Indications - Severe obstruction: cannot speak, weak or absent cough, noisy or absent breathing, hands at the throat. - Bluish skin or loss of consciousness from obstruction. - An infant who cannot cry or cough strongly after choking. ## Contraindications and precautions - Do not interfere with an effective cough: it can make the obstruction worse. - Do not try to pull the object out blindly with your fingers: it can push it further in. - Do not use abdominal thrusts in children under 1 year. - In pregnant or obese people use chest thrusts. - If breathing difficulty is not due to a foreign body (asthma, infection, allergy), do not use these manoeuvres: give CPR or treat the cause. ## Equipment - None for the manoeuvres: they are done with the hands. - Suction equipment and a bag-mask if the person loses consciousness. - Crash cart and AED if it progresses to arrest. ## Step by step (and why) - Ask "are you choking?" and see whether they can speak or cough — tells mild from severe obstruction. - If they cough strongly, encourage them to keep coughing and stay with them — coughing is the most effective way to clear it. - If they cannot cough or speak, call for help and stand to the side and behind, leaning them forward — the object comes out, not in. - Give up to 5 firm blows between the shoulder blades with the heel of your hand — the jolt and pressure can dislodge it. - If it does not come out, give up to 5 abdominal thrusts: fist above the navel, in and up — they raise the pressure in the chest. - Keep alternating per protocol until the object comes out or the person loses consciousness — do not stop while still blocked. - Infant: face down along your forearm, head lower, 5 back blows; then face up, 5 chest thrusts with two fingers. - If they lose consciousness: lay them on a firm surface, call the code and start CPR; look in the mouth before breaths. - Afterwards, have the person assessed and record what happened — the manoeuvres can cause internal injury. ## Complications - Internal (abdominal or chest) injury from the thrusts. - Rib fractures. - Vomiting and aspiration. - Cardiorespiratory arrest from hypoxia if the obstruction is not relieved. ## Next step: when to call for help - Anyone who received abdominal or chest thrusts should be assessed by a doctor, even if they seem well. - Report persistent cough, breathing difficulty, pain, hoarse voice or difficulty swallowing after the episode. - If the patient has dysphagia or repeated choking, report it so the diet and swallowing assessment can be reviewed. - Record the time, the manoeuvres and the response, and report the event under the protocol. ## Test yourself Think of the answer, then tap the question to see it. ## What do you do if a choking adult is coughing strongly and can speak? Do not intervene: encourage them to keep coughing and watch them, ready to act if it gets worse. ## What manoeuvres are used in a choking infant who cannot breathe? Cycles of 5 back blows (face down along the forearm, head lower) and 5 chest thrusts with two fingers. Never abdominal thrusts. ## What do you do if the choking person loses consciousness? Lay them on a firm surface, call for help and start CPR, looking in the mouth before each breath. ## What manoeuvre is used in a pregnant woman who is choking? Chest thrusts, with the fist on the middle of the breastbone, instead of abdominal thrusts. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/choking-foreign-body-airway-obstruction/) ## Connections ## Related 1 - [Basic life support from the nursing side](https://durgical.com/en/nursing/basic-life-support-from-the-nursing-side/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Choking - adult or child over 1 year](https://medlineplus.gov/ency/article/000049.htm) (MedlinePlus, U.S. National Library of Medicine, 2026); [Choking - infant under 1 year](https://medlineplus.gov/ency/article/000048.htm) (MedlinePlus, U.S. National Library of Medicine, 2026); [Nursing Assistant, 3.2: Emergency Situations](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Assistant_(Reuter)/03%3A_Maintain_a_Safe_Health_Care_Environment/3.02%3A_Emergency_Situations) (Chippewa Valley Technical College, Open RN remix (LibreTexts), 2022). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/nursing/choking-foreign-body-airway-obstruction/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/choking-foreign-body-airway-obstruction/