A 5-year-old boy while having dinner suddenly becomes aphonic and is brought to the causality with a complaint of respiratory distress. What should be the appropriate management

A large bolus of food obstructed, above the cords may make the patient totally aphonic, unable to cry for help. He may die of asphyxia unless immediate first aid measures are taken. The measures consist of pounding on the back, turning the patient upside down and following Heimlich manoeuvre. These measures should not be done if the patient is only paially obstructed, for fear of causing total obstruction. Heimlich manoeuvre: Stand behind the person and place your arms around his lower chest and give four abdominal thrusts. The residual air in the lungs may dislodge the foreign body providing some airway. Ref:PL DHINGRA textbook of EAR,NOSE & THROAT edition -7, page-367