How do you manage an alert adult with a severe airway obstruction?

• A. Deliver abdominal thrusts (Heimlich maneuver) until the object is expelled or the person becomes unable to continue.
• B. Encourage the person to cough softly and drink water.
• C. Perform chest compressions to relieve the obstruction.
• D. Provide rescue breaths only.

Answer: (D)

For a conscious adult with a severe airway obstruction, the priority is to relieve the blockage quickly with abdominal thrusts (the Heimlich maneuver). Stand behind the person, wrap your arms around their waist, make a fist with one hand and place it just above the navel. Grasp the fist with your other hand and perform quick, upward thrusts. Continue until the object is expelled and the person can breathe, speak, or cough effectively, or until they become unable to continue.

Providing rescue breaths only won’t clear the obstruction and can delay the needed effort to remove the object. Chest compressions aren’t the right first response for a conscious choking adult because they won’t dislodge the blockage and are reserved for when the person becomes unresponsive. If the person loses consciousness, then you would switch to CPR with rescue breaths and chest compressions, and you’d start clearing the airway if possible as you perform compressions.

If the airway becomes clear, the situation is resolved; if the person remains unable to breathe after your attempts, seek professional help immediately.