Children choking on an airway foreign object often show sudden symptoms like turning blue, violent coughing, vomiting, difficulty breathing, panic, and an inability to speak or cry. Adults may experience severe coughing, difficulty breathing, cyanosis, an inability to speak, and point to their throat (the universal choking sign). Without prompt intervention, these situations can become life-threatening.

Master, Doctor of Second Degree Tran Thi Thuy Hang, Head of the Department of Ear, Nose, and Throat at Tam Anh General Hospital, Ho Chi Minh City, advises that upon discovering or suspecting a child is choking on an airway foreign object, adults must remain calm. Do not attempt to remove the object from the child's mouth with your fingers; this could push it deeper, increasing the risk of aspiration and respiratory failure. If the child remains pink and can cry or speak, help them maintain a sitting position and promptly transport them to a medical facility for examination and foreign object removal. Most cases are safely managed with timely intervention. However, if the child is turning blue, has difficulty breathing, or cannot cry or cries weakly, call for an ambulance immediately and administer first aid while awaiting its arrival.

For children under two years old, adults can perform the back blow and chest thrust technique. Place the child face down, head lower than the body, on the rescuer's left arm, ensuring firm support for the head and neck. Use the heel of your right hand to deliver five sharp blows to the area between the child's shoulder blades. Then, turn the child onto their back on your other arm. If the child still has difficulty breathing or is turning blue, use two fingers to deliver five firm thrusts to the epigastric region (above the navel, below the breastbone). Alternate between back blows and chest thrusts until the foreign object is dislodged or the child can cry.

Doctor Hang advises a child's parent. *Illustration: Tam Anh General Hospital*.

For conscious adults choking on a foreign object, the Heimlich maneuver can be applied. The rescuer stands behind the person, wrapping both arms around their waist. Make a fist with one hand and place it in the epigastric region (above the navel). Grasp the fist firmly with the other hand. Deliver five distinct upward and inward abdominal thrusts per round. Repeat this 6-10 times until the foreign object is expelled or the person breathes and cries again. For pregnant women or obese individuals who are choking, chest thrusts can replace abdominal thrusts. Place your hands in the middle of the breastbone, then perform strong backward compressions.

If a person choking on a foreign object becomes unconscious, lay them on their back on a hard surface. The rescuer should kneel beside them, place the heel of one hand on the epigastric region (above the navel), place the other hand on top, and deliver strong, quick upward thrusts. If trained, perform cardiopulmonary resuscitation (CPR). Concurrently, call medical personnel for assistance. Even if the foreign object is dislodged, the person still needs to be taken to the hospital for examination to rule out any remaining foreign objects or airway damage.

Uyen Trinh