Most cases of foreign-body airway obstruction in adults occur while they’re eating. In children, foreign-body airway obstruction occurs most often when they’re eating or playing and typically involves such items as balloons, small objects, or such foods as hot dogs, rounded candies, nuts, or grapes. In infants, airway obstruction typically results from a liquid.

Foreign bodies can cause mild or severe airway obstruction. If the obstruction is mild and the patient is coughing forcefully, there’s no reason to intervene; spontaneous coughing and breathing typically relieve the obstruction.¹

If severe obstruction develops, you must intervene quickly to relieve the obstruction¹ because anoxia resulting from the obstruction may cause brain damage and death within 4 to 6 minutes. Intervene by administering abdominal thrusts, also called the Heimlich maneuver, which uses a subdiaphragmatic abdominal thrust to create diaphragmatic pressure in the static lung below the foreign body sufficient to expel the obstruction. Abdominal thrusts are used in conscious adult patients who can’t speak, cough, or breathe.

If abdominal thrusts are ineffective, you may consider administering chest thrusts; this maneuver forces air out of the lungs, creating an artificial cough. Use chest thrusts for an obese patient, if you’re unable to encircle the patient’s abdomen, and for a patient who’s in the late stages of pregnancy.¹ When administered to obese or pregnant patients who can’t speak, cough, or breathe, chest thrusts work by forcing air out of the lungs, creating an artificial cough.¹

For infants, deliver repeated cycles of five back blows followed by five chest compressions until the foreign body is expelled or the infant becomes unresponsive. Abdominal thrusts aren’t recommended for infants because they may damage the infant’s liver.

If a patient is unconscious or becomes unconscious despite your efforts, start cardiopulmonary resuscitation (CPR) immediately.