What is the recommended first aid response for a choking adult who cannot cough or speak?

• A. Perform abdominal thrusts (Heimlich maneuver) until the object is expelled or the person becomes unresponsive.
• B. Give back blows only while the person remains upright.
• C. Begin chest compressions immediately.
• D. Administer water to wash down the obstruction.

Answer: (A)

When an adult is choking and cannot cough or speak, the airway is completely blocked and the priority is to quickly dislodge the object. Abdominal thrusts (the Heimlich maneuver) accomplish this by producing a rapid increase in pressure inside the chest and abdomen, which propels air out of the lungs and forces the obstructing object out of the airway. Do these thrusts repeatedly until the object is expelled or the person becomes unresponsive. If they become unresponsive, lower them to the ground and start CPR, focusing on chest compressions and rescue breaths as you would for cardiac arrest, while checking the mouth for the object if it’s visible and easy to remove.

Back blows alone, while sometimes used in other scenarios, are not the most reliable sole method for an alert adult with a complete airway obstruction. Starting chest compressions immediately isn’t appropriate for a conscious choking adult, since the goal here is to relieve the blockage first. Giving water to wash down the obstruction can worsen the situation by adding fluid to a blocked airway and increasing the risk of aspiration.