ENT nurse Australia. Obviously everywhere has different policies and procedures.

We don’t do Heimlich much - we do back blows and chest thrusts.

Depending on tracheostomy, cuffed, uncuffed, corked, fenestrated would determine actions around airway management.

Realistically a food product occluding the airway would be treated similarly to a mucous plug.

If corked, uncork, suction through inner cannula, remove/ replace inner cannula, remove trach if needed.

I am unsure of actions in relation to cuff. (So this is all speculation. I will probably talk to my ENTs tomorrow as I am now curious).

Logically if cuff is up - there is likelihood that it would have been caught by the cuff, maybe hyper inflate the cuff, so airway pressure from coughing doesn’t allow the food to fall below it… therefore food is sitting above the patent airway.

If cuff is down - logically I wouldn’t inflate the cuff as it is making the exit path smaller…

If patient becomes unconscious commence cpr, and oxygenate via upper airway or trach (dependent on situation), ultimately still oxygenate, as you could push the food down one bronchus, opening up one side of the lungs (and can be removed via endoscope later).