Foreign body airway obstruction management. (Modified from Chandra, NC, and Hazinski, MF (eds): Textbook of Basic Life Support for Healthcare Providers, American Heart Association, Dalias, 1997.)

The trully choking child cannot speak, become cyanotic, and collapses
	Objectives	Actions
	Objectives	Adult (over 8 yr)	Child (1 to 8 yr)	Infant (under 1 yr)
CONSCIOUS VICTIM	1. Assessment: Determine airway obstruction	Ask, "Are you choking?" Determine if victim can cough or speak.		Observe breathing difficulty, ineffective cough, no strong cry.
	2. Act to relieve obstruction	Perform up to 5 diaphragmatic abdominal thrusts (Heimlich maneuver).		Give 5 back blows.
	2. Act to relieve obstruction			Give 5 chest thrusts.
	Be persistent.	Repeat Stop 2 until obstruction is relieved or victim becomes unconscious.
VICTIM WHO BECOMES UNCONSCIOUS	3. Position the victim: call for help.	Turn on back as a unit, supporting head and neck, face up, arms by sides. Call out, "Help!" Activate EMS. If second rescuer available, have person activate EMS.
	4. Check for foreign body.	Perform tongue-jaw lift and finger sweep.	Perform longue-jaw lift. Remove foreign object only if you actually see it.
	5. Give rescue breaths,	Open ifreairway with head-lilt/chin-lift Try to give rescue breaths. If airway is obstructed, reposition head and try to ventilate again.
	6. Act to relieve obstruction	Perform up to 5 subdiaphragmatic abdominal thrusts(Heimlich Maneuver).		Give 5 back blows.
	6. Act to relieve obstruction			Give 5 chest thrusts.
	7. Be persistent.	Repeat steps 4-6 until obstruction is relieved.
UNCONSCIOUS VICTIM	1. Assessment: Determine unresponsiveness.	Top or gently shake shoulder. Shout, "Are you okay?"	Top or gently shake shoulder.
	1. Assessment: Determine unresponsiveness.	If unresponsive, activate EMS.
	2. Call out for help: position the victim.	Turn on back as a unit, supporting head and neck, face up, arms by sides.
	2. Call out for help: position the victim.		Call out for help.
	3. Open the airway.	Head-tilt/chin-lift.		Head-tilt/chin-lift, but do not till too for.
	4. Assessment: Determine breathlessness.	Maintain on open oirway. Ear over mouth; observe chest, look, listen, feel for breathing (3-5 seconds).
	5. Give rescue breaths.	Make mouth-to-mouth seal.		Make mouth-to-nose-and-mouth seal.
	5. Give rescue breaths.	Try to give rescue breaths.
	6. If chest is not rising, try	Reposition head. Try rescue breaths again.
	7. Activate the EMS system		If airway obstruction not relieved after about 1 minute, activate EMS as rapidly as possible.
	8. Act to relieve obslruc-	Perform up to 5 subdiaphragmatic abdominal thrusts (Heimlich maneuver).		Give 5 back blows.
	8. Act to relieve obslruc-			Give 5 chest thrusts.
	9. Check for foreign body.	Perform tongue-jaw lift and finger sweep.	Perform tongue-jaw lift. Remove foreign object only if you actually see it.
	10. Rescue breaths.	Open the airways with head-tilt/chin-lift. Try opain Io give rescue breaths.
	11. Be persistent.	Repeat steps 8-10 until obstruction is relieved.