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Choking Maneuver and Airway Clearance

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Choking Maneuver and Airway Clearance

Key Points

  • If the person can cough forcefully, encourage continued coughing while monitoring closely.
  • If the person cannot cough, speak, or breathe, begin immediate airway-clearance intervention.
  • Continue thrusts until object expulsion or unresponsiveness, then transition to CPR protocol.

Equipment

  • No device required for immediate thrust technique
  • Emergency call/alert access
  • CPR support resources per facility protocol

Procedure Steps

  1. Recognize airway obstruction signs and immediately notify nurse or activate emergency response according to setting.
  2. If no nurse is available, direct another responder to call 911 while airway-clearance care continues.
  3. If the person is forcefully coughing, coach continued coughing and monitor deterioration.
  4. If the person cannot cough, speak, or breathe, state intent to assist and position behind the person.
  5. For standing adult, place one leg between victim’s legs for balance and reach around abdomen.
  6. For a child, move down to the child’s level and keep your head to one side during thrusts.
  7. Locate navel and place thumb side of fist above navel; grasp fist with other hand.
  8. Deliver quick inward-and-upward abdominal thrusts.
  9. For pregnant individuals, those you cannot get your arms around, or when abdominal thrusts are ineffective, deliver chest thrusts from behind while avoiding rib compression.
  10. If person is in wheelchair and cannot stand, lean forward safely and perform thrusts from behind.
  11. Continue thrusts until object is expelled or person becomes unresponsive.
  12. If unresponsive, notify nurse immediately; if no nurse is available, call 911 and initiate standard CPR sequence per training and policy.
  13. After relief of choking, seek medical evaluation and report event details to nurse.

Adult and child abdominal-thrust positioning examples for airway obstruction response Illustration reference: OpenRN Nursing Assistant Ch.3.2.

Common Errors

  • Delaying intervention when speech and breathing are absent → increases hypoxia and arrest risk.
  • Placing objects in mouth during distress → worsens obstruction and aspiration risk.
  • Incorrect thrust location (too high/too low) → reduces effectiveness and can cause injury.
  • Ending care without post-event medical evaluation → may miss residual airway injury or aspiration.

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