a. Partial Blockage With Good Air Exchange. If the person can speak or
cough forcefully, he has a partial blockage with good air exchange. (A partial blockage
means that the airway is not completely blocked and air can still get to and from the
person's lungs. Good air exchange indicates that the person can still inhale and exhale
enough air to carry on all life processes.) A person may have good air exchange even
though he makes a high-pitched sound between coughs. Encourage a person with
good air exchange to keep coughing until the obstruction is coughed up. Do not
interfere with his efforts. Do not leave the person since "good" air exchange can rapidly
deteriorate to "poor" air exchange or complete blockage, either of which can result in
unconsciousness and death. Be prepared to administer manual thrusts should his
b. Partial Blockage With Poor Air Exchange. If the person has a weak cough,
makes high-pitched noises (like crowing) while inhaling, or has a bluish tint around his
lips and fingernail beds, he has a partial blockage with poor air exchange. A person
with poor air exchange is not inhaling enough air to continue carrying on all life
processes. If the person is not helped, he will become unconscious and die. If a
person has poor air exchange, call for help and begin administering manual thrusts. If
possible, send someone to seek medical help.
If you cannot decide whether a conscious person has good or poor air
exchange, tell him to speak to you. If he does not speak, assume he
has an obstructed airway.
c. Complete Blockage. If the person's airway is completely blocked, he can
neither inhale nor exhale (no air exchange occurring). This means he cannot speak at
all. Quick action is needed to clear the airway. Call for help and begin administering
manual thrusts. If possible, send someone to seek medical help.
Do not slap a choking person on his back. Blows to his back may cause
the object to go down the airway instead of out of the airway.
A manual thrust acts like an artificial cough. Each thrust is performed with the
intent of dislodging the obstruction without having to perform additional