If a choking adult is unable to receive abdominal thrusts due to size, what is an alternative method?

Performing chest thrusts with hands on the lower breastbone is an effective alternative method for helping a choking adult who cannot receive abdominal thrusts. This technique is particularly useful because it applies pressure to the chest in order to create an artificial cough-like effect, which can help expel the object blocking the airway.

For individuals who may be too large for abdominal thrusts to be effective or safe—such as someone who is obese or pregnant—chest thrusts provide a feasible solution that can still clear the airway. The placement of hands on the lower breastbone ensures that sufficient force is applied directly to the chest, facilitating potential removal of the obstruction.

In contrast, other methods may not be suitable or effective. For instance, administering back blows with a fist is not a recognized or safe practice, as back blows should be given with the heel of the hand rather than a fist, and may not be effective when the person is in a specific size or position. Using a chair for support does not directly address the choking issue, and administering CPR immediately would only be appropriate in cases where the victim is unresponsive and not breathing, rather than when they are still conscious and attempting to clear their airway.