Unresponsive

Choking

3 of 3 lessons

The first question is whether the cough is working.

An effective cough — they can speak, cry, or cough loudly — needs encouragement and nothing else. Stay with them. Do not slap the back of somebody who is coughing effectively; you can dislodge the obstruction into a worse position.

An ineffective cough — silent, unable to speak or breathe, going blue:

  1. Five back blows. Lean them forward, heel of your hand between the shoulder blades, sharply. Check after each one.
  2. Five abdominal thrusts. Stand behind, fist above the navel and below the ribs, pull sharply inwards and upwards. Check after each one.
  3. Alternate five and five until it clears or they become unresponsive.

If they become unresponsive: lower them to the floor, call the emergency number, and start chest compressions.

Infants under one year: no abdominal thrusts. Five back blows and five chest thrusts, head lower than the chest, supported along your arm.

Afterwards. Anybody who has received abdominal thrusts must be seen by a doctor — the thrusts themselves can cause internal injury. So must anybody with a persistent cough, difficulty swallowing, or a feeling that something is still stuck.

Source. European Resuscitation Council, Guidelines 2021, Basic Life Support and First Aid, https://cprguidelines.eu/guidelines-2021

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