An airway obstruction occurs when a foreign object, such as food, partially or fully blocks the passage of air to the lungs, creating a medical emergency where every second counts. Recognizing the signs of this obstruction in a responsive person is paramount because oxygen deprivation can quickly lead to unconsciousness and severe complications. This situation demands immediate, specific action, making the ability to assess the severity of the blockage a fundamental skill for any bystander. Understanding the indicators allows for the correct intervention, potentially preventing a life-threatening scenario from escalating.
Clear Visual and Behavioral Indicators
The most widely recognized sign that a person is choking is the universal distress signal, where the individual instinctively clutches one or both hands to their throat. This reflex indicates an inability to breathe or speak, and it should immediately alert a bystander to a severe problem. A person experiencing an obstruction will often show intense signs of panic and agitation due to the sudden inability to take a breath.
The body’s struggle for air manifests in strained, visible efforts to inhale, which may produce a high-pitched sound known as stridor if the obstruction is partial. A person with a blocked airway may be unable to speak at all, or they may only manage to produce weak, high-pitched squeaks or sounds, signaling that insufficient air is moving past the vocal cords. As the obstruction continues, the lack of oxygen can lead to a bluish or grayish tint around the lips, face, and nail beds, called cyanosis. This discoloration signifies a rapidly worsening condition.
Distinguishing Between Mild and Severe Blockages
Determining the severity of the airway obstruction is the next step and directly influences the appropriate response. A mild, or partial, obstruction means that some air can still pass around the foreign object, allowing the person to maintain some level of airflow. In this scenario, the person can usually cough forcefully, speak, or make audible noises, although they may be wheezing or having difficulty.
The best approach for a person with a mild obstruction is to encourage them to continue coughing, as their own natural reflex is often the most effective method for dislodging the object. You should not immediately intervene with back blows or abdominal thrusts when the person is coughing forcefully, as this can potentially convert a partial blockage into a complete one.
A severe, or complete, obstruction is identified when the person cannot cough, speak, or breathe at all. The cough becomes silent or absent, and attempts to inhale may produce no sound, demonstrating that the airway is nearly or entirely blocked. This complete lack of effective air exchange requires immediate physical intervention.
Immediate Actions for Bystanders
Once a severe airway obstruction is identified, immediate action is required. The first step is to call emergency services or assign another person to do so immediately. For a conscious adult, the current recommended technique involves alternating five back blows and five abdominal thrusts, often referred to as the Heimlich maneuver, until the object is expelled.
To perform the back blows, stand to the side and slightly behind the person, supporting their chest with one hand, and deliver five sharp strikes between the shoulder blades using the heel of the hand. If the back blows are unsuccessful, transition to five abdominal thrusts. Stand behind the person, make a fist just above the navel, grasp it with the other hand, and deliver quick, inward and upward thrusts.
This cycle of five back blows followed by five abdominal thrusts is repeated until the foreign object is dislodged or the person loses consciousness. If the person becomes unresponsive, lower them gently to the ground and immediately begin cardiopulmonary resuscitation (CPR). Check the mouth for a visible object before attempting rescue breaths. Even after the object is cleared, seeking professional medical evaluation is recommended to assess for any internal injury.