What is the nurse's best immediate guidance for an infant choking on a marble while awaiting EMS?

• A. Five back blows followed by five chest thrusts
• B. Try to retrieve the object by inserting a finger in the mouth
• C. Perform the Heimlich maneuver
• D. Five abdominal thrusts followed by five back blows

Answer: (A)

The practice you’re testing is how to relieve a severe airway obstruction in an infant. For infants, the recommended immediate action is to deliver five back blows in a row, then five chest thrusts, and repeat those cycles while EMS is on the way. This approach uses gentle, age-appropriate airway clearance techniques that are safer for an infant's anatomy than abdominal thrusts. The back blows help dislodge the object by creating a focused force from the outside, and the chest thrusts apply inward pressure on the chest to push air up and out, helping to expel the marble without risking injury to the abdomen. Inserting a finger into the infant’s mouth to sweep out the object is not advised unless the object is clearly visible and easily reachable, because sweeping can push the object deeper or cause harm. The Heimlich maneuver, which uses abdominal thrusts, is not appropriate for infants due to their developing anatomy and the greater risk of injury. Continue the back blows and chest thrusts until the object is expelled or EMS arrives. If the infant becomes unresponsive at any point, begin CPR and check the mouth for the object when appropriate.