When a person who is choking suddenly loses consciousness, the situation shifts immediately to a medical emergency requiring Cardiopulmonary Resuscitation (CPR). This transition signals that the airway obstruction has caused a lack of oxygen, leading the brain to shut down. Immediate, precise action is necessary to circulate oxygenated blood and attempt to dislodge the foreign body using CPR chest compressions. This protocol maximizes the client’s chance of survival until professional medical help arrives.
Immediate Steps When Consciousness Is Lost
The moment the client becomes unresponsive, they must be safely lowered to the floor onto their back to ensure a firm surface for compressions. Supporting the head and neck during this process helps prevent additional injury from a sudden collapse.
Simultaneously, activate Emergency Medical Services (EMS) by calling 911 or the local emergency number immediately. If another person is present, delegate the call and instruct them to locate an Automated External Defibrillator (AED) and bring it to the scene. Although a quick check for breathing or a pulse should be performed, the priority in an unconscious choking victim is to begin chest compressions immediately to clear the airway obstruction.
Starting the Chest Compression Cycle
Once the client is positioned and help is summoned, the standard adult CPR protocol begins with chest compressions. Compressions are performed in the center of the chest, specifically on the lower half of the sternum. This physical force increases pressure within the chest cavity, which may help to expel the lodged foreign object.
To perform compressions effectively, place the heel of one hand on the sternum, with the second hand placed on top, fingers interlaced and lifted off the chest. Deliver compressions at a rate of 100 to 120 per minute (approximately two per second). The depth of each compression should be at least 2 inches but not exceed 2.4 inches, ensuring the chest fully recoils after each press.
The compression cycle uses a ratio of 30 compressions followed by two rescue breaths, with compressions being the primary focus for dislodging the object. Repeat this 30:2 cycle continuously until the object is expelled, the client begins to breathe, or EMS takes over. Before attempting rescue breaths, the rescuer must check the client’s mouth for the obstruction.
Visualizing and Clearing the Obstruction
The attempt to deliver rescue breaths is the moment to assess the airway and potentially remove the object. After 30 compressions, open the client’s mouth using the head-tilt, chin-lift technique. This maneuver helps align the airway passages, making it easier to see and potentially ventilate.
Only perform a finger sweep if the foreign object is clearly visible in the back of the throat or mouth. A “blind finger sweep,” where the rescuer attempts to feel for the object without seeing it, risks pushing the blockage further down the airway. If the object is visible, carefully remove it using a hooking motion with a finger.
If no object is seen, attempt the two rescue breaths, watching for the chest to rise. If the chest does not rise, the rescuer should reposition the head using the head-tilt, chin-lift and attempt the breaths once more. If air still does not enter, the airway remains blocked. Immediately return to the cycle of 30 chest compressions, repeating the process of checking for a visible object before the next attempt at rescue breaths.
Necessary Medical Follow-up
Regardless of whether the obstruction is cleared and the client revives, an immediate medical evaluation is mandatory. The intense physical force of chest compressions, while necessary for life-saving, carries a risk of internal injury to the ribs, lungs, or other organs. A medical professional must assess the client for potential complications from the resuscitation efforts and oxygen deprivation.
If the client begins breathing normally but remains unconscious, place them in the recovery position to maintain an open airway and prevent aspiration. Even if the person seems completely recovered and is speaking, they should not refuse transport to the nearest emergency facility. Any incident involving a loss of consciousness and resuscitation requires careful documentation and reporting in accordance with professional and organizational guidelines.