NCLIP

Choking Maneuver and Airway Clearance

2 min read

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 the person is forcefully coughing, coach continued coughing and monitor deterioration.
  3. If the person cannot cough, speak, or breathe, state intent to assist and position behind the person.
  4. For standing adult, place one leg between victim’s legs for balance and reach around abdomen.
  5. Locate navel and place thumb side of fist above navel; grasp fist with other hand.
  6. Deliver quick inward-and-upward abdominal thrusts.
  7. For pregnant individuals or when abdominal thrusts are not appropriate/effective, deliver chest thrusts from behind.
  8. If person is in wheelchair and cannot stand, lean forward safely and perform thrusts from behind.
  9. Continue thrusts until object is expelled or person becomes unresponsive.
  10. If unresponsive, initiate standard CPR sequence (compressions and rescue breaths) per training and policy.
  11. After relief of choking, seek medical evaluation and report event details to nurse.

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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