A partial airway obstruction may still permit a small amount of oxygen into the lungs. You can recognize a partial airway obstruction by the patient's ability to cough, speak or make noise. Ask the patient if they are choking. If they answer you or make noise, simply encourage them to cough in an effort to expel the foreign object. Your patient has far more power to expel the obstruction by coughing than you do. Never attempt to hit the patient on the back to clear the airway. This tactic, although great in movies, may turn a partial blockage into a complete one. After your patient has been coughing a while, one of two things will occur; the obstruction will dislodge and the airway will become clear or your patient will become unconscious from lack of oxygen.

If your patient becomes unconscious from an airway obstruction, it is necessary to call 911 and begin treatment. Once unconscious, the muscles of the airway will begin to relax and the obstruction may clear more easily. To clear an airway obstruction in an unconscious adult patient, first ensure your patient is lying flat on their back. As in the initial assessment, open the airway, look, listen and feel for breathing. If you see the object, remove it with your gloved fingers. Otherwise, attempt to ventilate the patient. If unable to ventilate, you will need to perform chest compressions. Kneel to the side of the patient and position your hand mid-sternum, mid-nipple line on the patient's bare chest. Place your other hand on top of the first. With your elbows locked and your knees shoulder Width apart, compress the sternum 1 1 /2 - 2 inches. This skill is similar to the type of thrusts performed during CPR.

A patient who is choking and has a complete airway obstruction will be unable to speak, cough or breathe. These patients may be frantic and combative out of fear. Swift action is required to help them regain a clear airway. First, establish the patient is choking by asking them. They will usually nod their head or point to their throat. You must then attempt to dislodge the obstruction using abdominal thrusts. This is also known as the Heimlich maneuver.

If you are choking, display the universal sign of choking by placing your hands to your throat and seek help. If there is no help around, you may be able to relieve the obstruction by placing the back of a chair just below your rib cage and falling against it. Be sure to use a hard-backed chair and place it well below your ribs. Holding onto the seat, lift the chair 12-15 inches off the ground and allow your weight to fall on it. If you are alone, you should call 91 1 and get help coming.

Women who are pregnant pose special problems when choking. Unfortunately, abdominal thrusts are contraindicated during pregnancy. Traditional abdominal thrusts can tear the placenta, which in turn can cause mother and baby to bleed profusely. This can lead to death for both of them. Therefore, we recommend using chest thrusts to treat any airway obstruction in a pregnant woman.

To accomplish this, stand behind the conscious, pregnant woman and wrap your arms around her chest about mid-sternum level. Make a fist with one hand and grab that fist with your other hand. Rapidly squeeze your fists toward you. This skill compresses the sternum against the lungs and, will hopefully force out enough air to release the obstruction. If the pregnant woman becomes unconscious, place her on her back and perform chest compressions and ventilations. The key to properly treating any airway obstruction is to recognize it is occurring, rapidly notify EMS and perform the Drone proper skill to correct the type of obstruction you are faced with.