What is the correct first step of the Heimlich maneuver for dislodging an airway obstruction in an adult?

• A. Administer one hard blow with the back of your hand to the chest.
• B. Provide two blows to the lower back with the heel of your hand.
• C. Administer five back blows with the heel of your hand between the shoulder blades after bending the person at the waist.
• D. Administer three blows to the lower back with the back of your hand.

Answer: (C)

The technique for an adult who is conscious and choking starts with back blows to create an initial push to dislodge the object. Have the person bend forward at the waist, stand behind them, and strike firmly between the shoulder blades with the heel of your hand. Do five quick back blows in this position because directing the force to the upper back uses gravity and chest-area leverage to help push the obstruction out of the airway. If the object isn’t expelled after these five blows, the next step is to follow with abdominal thrusts, but the first move in this sequence is the five back blows as described. The other options describe actions that aren’t the recommended starting move for an adult’s airway obstruction.