Airway obstruction (Foreign Object)

Airway obstruction can lead to respiratory and cardiac arrest if not addressed quickly and effectively. A conscious patient clutching his/her throat is showing the universal sign of choking.

Resuscitation Council (UK) Resuscitation Guidelines 2015 Guidelines:

“GIVE BACK BLOWS" 

If cough becomes ineffective give up to 5 back blows

Stand to the side and slightly behind the victim

Support the chest with one hand and lean the victim well forwards so that when the obstructing object is dislodged it comes out of the mouth rather than goes further down the airway

Give five sharp blows between the shoulder blades with the heel of your other hand

GIVE ABDOMINAL THRUSTS

If back blows are ineffective give up to 5 abdominal thrusts

Stand behind the victim and put both arms round the upper part of the abdomen

Lean the victim forwards

Clench your fist and place it between the umbilicus (navel) and the ribcage

Grasp this hand with your other hand and pull sharply inwards and upwards

Repeat up to five times

If the obstruction is still not relieved, continue alternating five back blows with five abdominal thrusts

START CPR

Start CPR if the victim becomes unresponsive

Support the victim carefully to the ground

Immediately activate the ambulance service

Begin CPR with chest compressions

Figure 7.
Abdominal thrusts to remove foreign objects

If the patient becomes unresponsive, immediately begin CPR with chest compressions and make sure an AED is readily available. Each time the airway is opened to give ventilations, look for any visible objects in the oropharynx. If an object can be seen, remove it (if possible) using a finger sweep motion (Figure 8). If a foreign object is not visible, a blind finger sweep should not be performed; continue CPR, cycles of 30 compressions and 2 ventilations, until EMS arrives.

Figure 8.
finger sweep motion to remove foreign object
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