What to do
- Strong cough and breathing: encourage coughing and stay close. If unable, shout for help. Have someone call while you act.
- Awake but coughing ineffectively: lean forward, support chest and give up to 5 hand-heel blows between shoulder blades. Check after each.
- If blows fail: pregnancy or abdomen you cannot encircle → chest thrusts, never abdominal thrusts. Other adults → abdominal thrusts.
- Wheelchair: kneel behind if needed for thrusts. Abdomen unreachable: chest thrusts. Do not delay with a difficult transfer. Ask dispatcher for help.
- Only a non-pregnant adult whose abdomen you can encircle: from behind, fist between navel and bottom of chest. Grasp with other hand. Up to 5 sharp inward/upward pulls.
- For the exception: stand firmly behind. Thumb side of fist against the breastbone. Grasp with other hand. Up to 5 quick pulls straight back toward you. Check after each.
- Pregnancy or abdomen cannot be encircled: alternate up to 5 back blows and up to 5 chest thrusts. Stop for strong cough or breathing. Unresponsive: adult CPR.
- If still blocked, call now if not done. Alternate up to 5 blows/up to 5 thrusts of the selected type. Stop if strong cough or breathing returns.
- If unresponsive, start adult CPR with compressions. Follow dispatcher. Remove only a visible easily reached object.
- After abdominal or chest thrusts, get medical assessment even if the object comes out.
- Unable to reach the chest or position safely: call now and ask another helper. Loss of response: dispatcher-guided CPR. Do not improvise a solo lift.
What to avoid
- No blind finger sweeps. Remove only a visible, easily reached object.
2026-10-03-draft-48