Acute Airway Obstruction
Stepwise clearing and securing of the obstructed airway using basic manoeuvres and adjuncts available at upazila level. Noisy breathing is obstructed breathing; silence in a struggling patient is worse.
Checklist— tick steps as you go
0/16 steps done
1Recognise
2Open and clear
3Maintain
4Escalate
Decision flowchart
Noisy or absent breathing
Is the patient conscious?
Yes
Choking on a foreign body?
Yes
5 back blows, then 5 abdominal thrusts; repeat cycles
Airway clear and stable?
Yes
Continue the ABCDE assessment
No
Urgent referral for definitive airway; continue BVM en route
Continue the ABCDE assessment
No
Sit up, high-flow O2, treat the cause (adrenaline IM if anaphylaxis)
Airway clear and stable?
Yes
Continue the ABCDE assessment
No
Urgent referral for definitive airway; continue BVM en route
Continue the ABCDE assessment
No
Head tilt-chin lift or jaw thrust; suction under vision
Breathing adequately now?
Yes
OPA or NPA, recovery position, O2, monitor
Airway clear and stable?
Yes
Continue the ABCDE assessment
No
Urgent referral for definitive airway; continue BVM en route
Continue the ABCDE assessment
No
Bag-valve-mask ventilation, call for help
Airway clear and stable?
Yes
Continue the ABCDE assessment
No
Urgent referral for definitive airway; continue BVM en route
Continue the ABCDE assessment
Educational guidance only — adapt to your resources, scope of practice and local policy. Last updated 12 August 2026.