b'Ineffective Cough (Severe Airway Obstruction)ChapterHow to ManageAdult & Child Above 1 YearConscious PatientCall Ambulance 000. Remove/clear any visible obstruction with yourfingers if possible.Lean the patient forward or supported overthe back of a chair. The patient may also be placed into the recovery position.Position yourself slightly behind and to theside of the patient.Give up to 5 sharp back blows with the heelof your hand between the shoulder blades, using an upward motion.Check after each back blow to determine ifthe obstruction has been relieved.The aim is to dislodge the obstruction witheach back blow rather than to give all 5 backblows in succession. f the obstruction is cleared, place the patient Iin the recovery position and closely monitor.If the airway is still obstructed and the back blows are not effective, give up to 5 sharp, slow chest thrusts.If the patient is upright or in the recovery position,place one hand in the middle of the patients back for support and the heel of your other hand on the same compression point (centre of the chest) as for CPR. Alternatively, chest thrusts may be given with the patient lying on their back.Chest thrusts are given in a similar way as chestcompressions but are sharper and delivered at a slower rate.Check after each chest thrust to determineif the obstruction has been relieved. f the obstruction is cleared, place the patient in the Irecovery position and closely monitor.64 Choking (Airway Obstruction)'