The scenario of a person actively choking who suddenly loses consciousness represents a rapid and dangerous medical emergency. When the victim of a severe airway obstruction becomes unresponsive, standard first aid techniques like back blows or abdominal thrusts must stop immediately. This loss of consciousness signals that oxygen deprivation has progressed to the point of collapse. The response must shift from trying to dislodge the object to actively circulating oxygenated blood and attempting to force the obstruction out using chest compressions. This requires a focused sequence of actions addressing both the foreign body airway obstruction and the resulting loss of responsiveness.
Immediate Actions and Activation of Emergency Services
The first priority upon recognizing an unresponsive choking person is to ensure their safety and activate professional medical help. Gently lower the person to a firm, flat surface, such as the floor, which is necessary to perform effective chest compressions. Attempt to check for responsiveness by tapping the victim’s shoulder and shouting loudly, but do not waste time searching for a pulse.
If the person remains unresponsive, immediately shout for help to attract bystanders. Direct a specific person to call emergency services, like 911, and to retrieve an Automated External Defibrillator (AED) if one is available nearby. If you are alone, you must activate the emergency response system yourself before beginning the hands-on rescue sequence. Activating emergency medical services (EMS) is important, as bystander intervention cannot replace the definitive care provided by paramedics.
Executing the Modified CPR Sequence for Airway Obstruction
Once the victim is positioned and professional help is on the way, the rescuer must begin a modified cardiopulmonary resuscitation (CPR) sequence. This technique uses the mechanical force of chest compressions to increase pressure within the chest cavity, potentially expelling the lodged object. Start with a cycle of 30 rapid compressions, placing the heel of one hand on the center of the person’s chest, with the other hand interlaced on top.
The compressions should be delivered at a rate of 100 to 120 per minute, pushing down at least two inches deep for an average adult. These compressions circulate oxygenated blood and function as an artificial cough, creating pressure behind the blockage. After completing the 30 compressions, the focus shifts to the airway.
The next step involves opening the victim’s mouth using the head-tilt/chin-lift maneuver and visually inspecting the back of the throat. This is the modification to standard CPR; the rescuer must look for the obstructing object. Only if a foreign body is clearly visible should the rescuer attempt to remove it with a finger sweep. Blindly sweeping the throat is not recommended, as it risks pushing the object deeper into the airway.
Following the visual check, the rescuer attempts to deliver two rescue breaths. Pinch the person’s nose closed, create a seal over their mouth, and breathe in for about one second, watching for the chest to rise. If the first breath does not make the chest rise, the airway should be immediately repositioned using the head-tilt/chin-lift maneuver, and a second breath should be attempted.
If the chest still does not rise after the second attempted breath, the airway obstruction remains in place. The rescuer must immediately return to the chest compressions to continue generating pressure to dislodge the object. The cycle of 30 compressions, visual check, and 2 attempted breaths must be repeated continuously until the foreign body is successfully expelled, the person shows signs of life, or emergency medical personnel arrive.
Post-Intervention Steps and Transition to Medical Care
Once the obstruction is cleared and the person begins breathing normally, or if EMS arrives, the rescuer’s role transitions to monitoring and handover. If the person regains consciousness and is breathing effectively, they should be placed in the recovery position. This involves gently rolling the victim onto their side, which helps keep the airway open and allows fluids to drain safely.
Continuous monitoring of the victim is necessary, even if they appear fine immediately after the event. The victim’s breathing rate, level of consciousness, and skin color must be checked repeatedly until medical professionals take over. Internal injuries from compressions or damage from the foreign body may not be immediately apparent.
When paramedics arrive, the rescuer must provide a clear report detailing the events. This handover should include information on what was choking the person, how long they were unresponsive, and the specific steps taken, such as the number of modified CPR cycles performed. Providing this detail aids the medical team in their treatment decisions.
Seeking a medical evaluation is advised even after a successful rescue. The forceful nature of chest compressions can cause injuries, such as broken ribs or sternum fractures, which require professional assessment. Furthermore, the risk of secondary complications, like aspiration pneumonia, necessitates a thorough medical check.