A 56-year-old female has a complete airway obstruction from a piece of food. She becomes unconscious while you assess her. What should you do?

In the scenario of a complete airway obstruction, the priority is to resolve the obstruction and ensure adequate oxygenation. When the patient becomes unconscious, their respiratory drive is compromised, significantly increasing the urgency of the situation.

Beginning chest compressions is appropriate because, in the context of a complete airway obstruction, the patient is unable to breathe, and within seconds, brain and organ damage can begin due to lack of oxygen. Chest compressions help to circulate any residual blood and maintain perfusion to vital organs until definitive airway management can occur. While delivering compressions, it may also be possible to perform visual checks for the obstructing object and to utilize airway adjuncts, but the immediate need is to ensure blood flow.

Other potential measures, such as abdominal thrusts, would not be effective while the patient is unconscious and could cause further injury. Mouth-to-mouth breathing would not resolve the obstruction and could expose the rescuer to risk without providing effective ventilation. An oropharyngeal airway could facilitate airway management, but without the ability to ventilate due to the obstruction, initiating chest compressions takes precedence to support circulation.