A foreign body airway obstruction is a life-threatening emergency which follows the lodgement of a foreign object in the casualty's airway. In some instances, the object lodges at the epiglottis, the entry to the airway, but does not actually enter the airway itself. Both situations cause initial coughing, which is the body's reflex action to dislodge the object

If an object is firmly lodged in the airway, coughing at least keeps it high in the trachea, though may not expel it. However, coughing with an object at the entrance to the airway will generally cause it to be expelled.

Should you encounter a person with an apparent obstruction who is coughing effectively, DO NOT SLAP them on the back. If the obstruction is at the entrance to the trachea, then reactions to the slaps may cause the person to inhale the object and cause complete obstruction.

If a casualty appears to be in increasing distress, then the object may be totally obstructing the airway.

Partial Obstruction

• difficulty in breathing
  
• wheezing
  
• snoring sound
  
• persistent cough
  
• cyanosis (blue skin colour)
  
• in children and infants
  
  • flaring of the nostrils
    
  • in-drawing of the tissues above the sternum and in between the ribs

• encourage the casualty to keep coughing
  
• if blockage has not been cleared call ‘000' for an ambulance
  
• reassurance
  
• DO NOT slap the casualty with a partial obstruction on the back

Complete Obstruction

• unable to breathe, speak or cough
  
• agitated and distressed
  
• may grip the throat
  
• bluish skin colour
  
• rapid loss of consciousness

Conscious casualty

• position yourself to deliver back blows
  
  • stand slightly behind and to the side of the casualty
    
  • support the chest with one hand
    
  • lean the casualty well forward
    
• deliver up to five firm back blows between the shoulder blades using the heel of the hand
  
• check mouth and clear any obstructions that may have come loose after each back blow
  
• deliver up to five chest thrust
  
  • chest thrusts are given in a similar way to chest compressions but are sharper and delivered at a slower rate. Place your hand in the centre of the chest as for CPR
    
• check mouth and clear any obstructions that may have come loose after each chest thrust
  
• repeat back blows and chest thrusts if obstruction not relieved

Unconscious casualty

• support the casualty carefully to the ground
  
• call ‘000' for an ambulance
  
• commence CPR