A conscious adult with a severe foreign body airway obstruction remains unable to cough. What is the recommended action?

• A. Abdominal thrusts (Heimlich maneuver) until obstruction is relieved or the patient becomes unresponsive
• B. Tap on back
• C. Wait for spontaneous relief
• D. Hyperextend neck

Answer: (A)

When a conscious adult is severely choking and cannot cough, you need to actively clear the airway by rapidly increasing airway pressure. Abdominal thrusts do this effectively by forcing air up from the lungs to dislodge the obstruction. You perform quick inward and upward thrusts just above the navel and continue until the object is expelled or the person loses consciousness. If they become unresponsive, lower them and start CPR, checking the mouth for a visible object and removing it if you can see it. Neck hyperextension won’t help and can make the situation worse, and waiting for spontaneous relief is unsafe in a complete obstruction.