Unconscious Adult Choking

Video 16 of 20
2 min 40 sec
English, Español
English, Español

In this lesson, we'll cover how to help an adult choking victim who is unconscious. In our fictional scenario, the adult victim went unconscious while you were trying to help them.

The method of care will closely resemble performing CPR, which you recently learned, however, there are subtle differences to pay attention to.

How to Provide Care

As always, the first thing you want to do is make sure the scene is safe and that your gloves are on, and that you have your rescue shield handy.

  • Help lower the victim to the ground or floor, so they don't fall and injure themselves. Pay extra attention to supporting their head and neck.
  • Call 911 and activate EMS if you haven't already done so.
  • Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum.
  • Stand or kneel directly over the victim's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them.

Pro Tip #1: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm.

Remember to make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart.

  • Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second.
  • Perform 30 chest compressions.

Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression.

Pro Tip #2: There are no complications when performing chest compressions on a pregnant woman, as you're not near the womb and baby when doing them. Proceed as you would for any other adult patient.

  • Lift the victim's chin and tilt his or her head back.
  • Look inside their mouth. See if any obstructions came loose from the chest compressions. If you see something, sweep it out using your finger. If you don't, continue with the following steps.
  • Grab the rescue shield and place it over the victim's mouth and nose.
  • Pinch the victim's nose and open their mouth.
  • Deliver a rescue breath and watch for the victim's chest to rise. If the chest doesn't rise, reposition the head and chin and try again. If the second breath also doesn't result in a chest rise, go right back into your 30 chest compressions.
  • Look in their mouth again after the 30 chest compressions. If you see an object, sweep it out and try two more rescue breaths.
  • If the rescue breaths go in this time – causing the chest to rise and fall – reassess the victim for signs of breathing normally and/or responsiveness.

Pro Tip #3: Let's assume your compressions were able to dislodge the obstruction and you got it out of the victim's mouth. At this point, either they're breathing normally and becoming more responsive, or they're not. If not, continue to perform 30 compressions to two rescue breaths.

Continue to perform CPR until EMS arrives, an AED is located, someone equally trained relieves you, or the victim becomes responsive and begins breathing normally again.

How You can Increase the Effectiveness of CPR

It's important to understand what constitutes high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. With that in mind, here are two lists (cheat sheets) to use when practicing CPR – one list of what to do and what of what NOT to do.

What is High-Quality CPR?

  • Performing chest compressions at a rate of 100-120 per minute
  • Compressing to a depth of at least 2 inches but not exceeding 2.4 (for adults)
  • Allowing for full recoil after each compression
  • Minimizing pauses in compressions
  • Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the victim's chest to rise

What is Low-Quality CPR?

  • Compressing at a rate slower than 100 per minute or faster than 120 per minute
  • Compressing to a depth of less than two inches or greater than 2.4 inches
  • Leaning on the chest between compressions or performing compressions while not directly over the victim's heart
  • Interrupting compressions for greater than 10 seconds
  • Providing excessive ventilation – too many breaths or breaths with excessive force