Mechanical

Foreign body / choking / upper airway obstruction

Before / During / After / Pitfalls

Before

• Assess whether BLS obstruction maneuvers, suction, Magill removal, bronchoscopy/ENT, or cric pathway is most appropriate.
• Have suction, Magills, VL/DL, forceps, and backup surgical airway ready.
• Avoid pushing the object deeper.

During

• Visualize before manipulating; remove only if safely reachable.
• Maintain oxygenation; consider rigid bronchoscopy/OR pathway if distal object.
• If cannot ventilate/cannot oxygenate, declare CICO and move to front-of-neck access.

After

• Evaluate aspiration, airway trauma, residual obstruction.
• CXR/bronchoscopy/ENT/peds pathway depending on object and age.
• Debrief object management and rescue timing.

Pitfalls

• Blind finger sweeps.
• Pushing object below cords.
• Repeated laryngoscopy without oxygenation.