What is the recommended approach if a choking adult becomes unconscious on board?

• A. Begin CPR with chest compressions and ventilations and use the AED; do not perform abdominal thrusts on an unconscious person.
• B. Attempt to remove the obstruction again with finger sweep while unconscious.
• C. Wait for EMS to arrive before acting.
• D. Shake the person vigorously to dislodge the blockage.

Answer: (A)

When a choking adult becomes unconscious, the priority shifts to resuscitation: start CPR immediately with chest compressions and rescue breaths, and have the AED ready to use as soon as available. Abdominal thrusts aren’t performed on an unconscious person because there’s no safe way to clear the airway with that maneuver when the person isn’t conscious to respond or protect the airway, and it can cause injury.

Continuing CPR helps restore circulation and ventilation, which can both oxygenate the blood and, in some cases, dislodge the obstruction as air moves in and out. If a visible obstruction is present in the mouth, you may remove it with a finger sweep only if you can do so without pushing the object deeper; otherwise focus on compressions and ventilations and defer aggressive airway maneuvers. Use the AED as soon as it’s available, following its prompts.

Delaying action, or trying nonairway-focused motions like shaking, isn’t appropriate. Waiting for EMS or other steps would waste precious seconds when prompt CPR and AED use offer the best chance of recovery.