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Adult choking algorithm

Foreign body airway obstruction
Suspect choking if someone is suddenly unable to speak or talk, particularly if eating.
Encourage the person to cough.
If the cough becomes ineffective, give up to 5 back blows:
Lean the person forward.
Apply blows between the shoulder blades using the heel of one hand.
If back blows are ineffective, give up to 5 abdominal thrusts:
Stand behind the person and put both your arms around the upper part of their abdomen.
Lean the person forwards.
Clench your fist and place it between the umbilicus (navel) and the ribcage.
Grasp your fist with the other hand and pull sharply inwards and upwards.
If choking has not been relieved after 5 abdominal thrusts, continue alternating 5 back blows with 5 abdominal thrusts until it is relieved, or the person becomes unresponsive.
If the person becomes unresponsive, start CPR.


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