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SERA Foreign Body Airway Obstruction

How to help someone who is choking

Adult Choking Guidelines

When encountering adult casualty who is choking, knowing what to do in that split seconds can help to save his lives! When someone is choking, they experience either complete airway obstruction or incomplete airway obstruction. Coughing is the body’s natural defence against airway obstruction.

Complete airway obstruction

Complete airway obstruction is an emergency that will result in death within minutes, if not treated immediately. A casualty can develop airway obstruction from either intrinsic (tongue and epiglottis) or extrinsic (foreign body) causes.

Intrinsic Causes

  • The tongue can fall back into the pharynx in an unconscious casualty in the supine
  • Blood from the head and facial injuries can flow into the
  • Regurgitated stomach contents can enter the

Extrinsic Causes

  • Foreign bodies, e.g. food, dentures etc.

Contributing Factors

  1. Large poorly chewed pieces of meat/food.
  2. Elevated blood alcohol
  3. Dentures
  4. Playing, crying, laughing and talking with food in the


  1. Cut food into small pieces. Chew slowly and thoroughly, especially if wearing dentures
  2. Avoid excessive intake of alcohol
  3. Avoid laughing and talking when the mouth is full

For complete (severe) airway obstruction, the casualty is unable to:

  1. Speak, breathe or cough
  2. May become cyanotic (blue).

The casualty will also clutch the neck with thumb and fingers, the universal distress signal for choking that requires immediate action.

Adult Choking

Watch the video to learn how you can help someone who is choking.

Pictorial Guide on assisting an Adult who is choking

Helmich Manoevour:

How to perform Helmich Manoevour on normal size casualty.

Chest Thrust Manoevour:

How to perform Chest Thrust on Pregnant or Obese casualties

Incomplete Airway Obstruction

A casualty with partial (mild) airway obstruction will cough to expel the foreign body. If the casualty is wheezing (breathing noisily with a wheezing sound) or coughing, this means that the airway is partially obstructed. Do not interfere. Allow the casualty to cough to expel the object himself/herself.

Information Adapted from Singapore Resuscitation and First Aid Council’s Basic Cardiac Life Support’s guidelines.