What should you do if a four-year-old male with a complete foreign body airway obstruction becomes unconscious and his chest does not rise during ventilations?

In the scenario of a four-year-old male experiencing a complete foreign body airway obstruction who becomes unconscious, starting chest compressions immediately is essential because the child is unresponsive and unable to manage his airway.

When a child is unconscious and does not show any rise in the chest during attempted ventilations, it indicates that air cannot enter the lungs due to the obstruction. In this case, the first priority is to clear the airway effectively to restore ventilation. While abdominal thrusts (also known as the Heimlich maneuver) are typically used in cases of conscious choking to dislodge an obstruction, in an unconscious individual, the process must shift to more immediate measures to ensure that compressions help circulate blood and potentially expel the obstruction.

Starting chest compressions serves a dual purpose: maintaining some level of blood circulation and potentially generating enough pressure in the thoracic cavity to expel the foreign object. After starting compressions, the rescuer can also check the mouth for visible obstructions and attempt to remove any dislodged object if found.

Options that focus on back blows, abdominal thrusts, or placing the child in a recovery position are not appropriate in this particular context because they do not address the immediate need for ventilation and circulation support in an unconscious patient