BLS Adult Choking Algorithm - 2025 Guidelines Coming Soon

Choking is a life-threatening emergency that can happen to anyone, anywhere. Knowing the correct steps to take can make the difference between life and death. For healthcare professionals and trained first responders, the BLS Adult Choking Algorithm provides a standardized, effective approach to managing this crisis.

The Basic Life Support (BLS) guidelines, established by the American Heart Association (AHA), offer a clear sequence of actions. Understanding this protocol is crucial for anyone with BLS certification, as it ensures a systematic and proven response. Let’s walk through the process for a conscious adult who is choking.

What is BLS Adult Choking Algorithm

The BLS Adult Choking Algorithm is a structured set of actions designed for managing a Foreign-Body Airway Obstruction (FBAO) in adults. The initial and most critical step is to determine the severity of the obstruction. Is the person able to cough, speak, or breathe? Their ability to do so will guide your next actions.

Step 1: Assess the Severity of Choking

First, ask the person, “Are you choking?” A person with a severe airway obstruction will not be able to speak, cough, or breathe. They may use the universal sign for choking by clutching their throat with one or both hands.

Mild Airway Obstruction:

If the person can cough forcefully, speak, or make sounds, the airway is only partially blocked. In this case:

Encourage them to keep coughing. A strong cough is the most effective way to clear an obstruction.
Stay with the person and monitor their condition.
Do not interfere with their attempts to cough.
Be prepared to act if the mild obstruction becomes severe.

Severe Airway Obstruction:

If the person cannot speak, cough, or breathe, or makes high-pitched noises while inhaling, the obstruction is severe. This is a true emergency, and you must act immediately.

Step 2: Perform Abdominal Thrusts (Heimlich Maneuver)

For a conscious adult with a severe airway obstruction, the recommended action is to perform abdominal thrusts, also known as the Heimlich maneuver.

How to Perform Abdominal Thrusts:

Position Yourself: Stand behind the person. If they are much taller than you, you can have them sit in a chair.
Wrap Your Arms: Place one foot between their feet to create a stable base. Wrap your arms around their waist.
Make a Fist: Make a fist with one hand. Place the thumb side of your fist against the person’s abdomen, just above the navel and well below the breastbone.
Grasp and Thrust: Grasp your fist with your other hand. Deliver quick, upward thrusts into the abdomen. Each thrust should be a distinct attempt to dislodge the object.
Continue Thrusts: Repeat these thrusts until the object is expelled and the person can breathe, or until they become unresponsive.

Step 3: Special Considerations for Certain Individuals

The standard abdominal thrust technique may need to be modified for pregnant individuals or people with larger body sizes where you cannot wrap your arms around their waist.

For Pregnant or Obese Individuals: Perform chest thrusts instead of abdominal thrusts. Position your hands in the center of the person’s chest, on the lower half of the breastbone. Deliver firm, inward thrusts, similar to the motion of chest compressions but more forceful.

Step 4: What to Do If the Person Becomes Unresponsive

If your efforts to relieve the choking are unsuccessful and the person loses consciousness, you must transition to a different set of actions within the BLS algorithm.

Call for Help: If you are not alone, send someone to call 911 or your local emergency number. If you are alone, provide about two minutes of care before leaving to call for help yourself.
Lower the Person to the Ground: Carefully lower the person onto a firm, flat surface.
Begin CPR: Start high-quality CPR, beginning with chest compressions. The standard rate is 100 to 120 compressions per minute.
Check the Airway Before Breaths: Each time you open the airway to give rescue breaths, look in the person’s mouth for the obstructing object. If you see an object that can be easily removed, use your finger to sweep it out. Do not perform a blind finger sweep, as this could push the object deeper into the airway.
Continue CPR: Continue the cycle of 30 chest compressions and 2 rescue breaths until the person begins to breathe on their own, an AED becomes available, or emergency medical services arrive to take over.

The force from the chest compressions can sometimes be enough to dislodge the foreign object, which is why checking the airway before giving breaths is a critical step.

Master the BLS Algorithm with Professional Training

Knowing the BLS Adult Choking Algorithm is an essential skill for healthcare providers and a valuable asset for anyone. While reading about the steps is a great start, nothing replaces hands-on practice. Proper training ensures you can perform these life-saving maneuvers correctly and confidently when it matters most.

At Safety Training Seminars, we provide comprehensive, American Heart Association (AHA)-certified BLS courses that cover choking emergencies for adults, children, and infants. Our blended learning format combines a convenient online course with a brief, in-person skills session at one of our 70+ locations across California. This approach guarantees you receive high-quality training that fits your schedule. Our experienced instructors will guide you through hands-on practice, ensuring you master the techniques needed to save a life. Ready to gain the skills and confidence to act in an emergency? Book an appointment with us and get your certification card the very same day.