Which Pre-Arrival Protocol would you use for an unconscious, adult choking victim?

• A. Protocol A
• B. Protocol B
• C. Protocol D
• D. Protocol C

Answer: (D)

When someone is unconscious and choking, you must shift to a resuscitation sequence that prioritizes airway management and oxygenation, followed by circulation. Back blows and abdominal thrusts are not used because the person cannot respond and the airway may be compromised, so the appropriate protocol guides you to start CPR with rescue breaths while you attempt to clear the airway if you can see and reach the obstruction.

Open the airway (head-tilt and chin-lift unless you suspect spinal injury), give two rescue breaths and watch for chest rise. If the breaths do not go in, reposition and try again. Then begin high-quality chest compressions with a 30:2 compression-to-breath ratio, continuing cycles. If you can see the obstruction, remove it only if you can reach it safely and clearly; avoid blindly sweeping the airway with fingers. Keep CPR going until help arrives or the person regains effective breathing.

Other protocols would apply to conscious choking or to different populations (like infants), but they don’t fit an unconscious adult scenario, so this protocol is the one that aligns with treating an unconscious choking adult.