Management of complete airway obstruction
The guidelines for this topic vary according to whether your territory falls under the American Heart Association (AHA) or the European Resuscitation Council (ERC). Please choose which guidelines you'd like to learn about.
American Heart Association guidelines
This section is based on the American Heart Association guidelines
Abdominal thrusts
Stand behind the casualty and reach your arms around them, gripping your hands in the pit of the stomach. Pull the hands forcefully upwards and backwards under the ribs. Repeat this five times if the obstruction is not relieved. Signs that the obstruction has been relieved include less distress in the casualty or a more effective cough.
If the casualty deteriorates and stops breathing, place them on the floor and commence CPR. Be aware that often chest compressions will dislodge the obstruction which may sit at the back of the throat. The same technique of abdominal thrusts is used on children.
European Resuscitation Council guidelines
This section is based on the European Resuscitation Council guidelines
Back slaps
Stand behind the casualty and bend them slightly forward. With the heel of your hand, hit them firmly upwards between the shoulder blades, as if you are pushing the obstruction upwards and out of the mouth. Repeat this five times and check each time to see if the obstruction has been relieved.
Abdominal thrusts
If back slaps have been unsuccessful in removing the obstruction, stand behind the casualty and reach your arms around them, gripping your hands in the pit of the stomach. Pull the hands forcefully upwards and backwards under the ribs. Repeat this five times if the obstruction is not relieved. Then revert to backslaps. Signs that the obstruction has been relieved include less distress in the casualty or a more effective cough.
If the casualty deteriorates and stops breathing, place them on the floor and commence CPR. Be aware that often chest compressions will dislodge the obstruction which may sit at the back of the throat.
If this occurs in small children, it is acceptable to place them over the knee when delivering back slaps.
Adult choking treatment (courtesy of Resuscitation Council UK)