What is the first action to take if a patient is choking and unable to speak?

When a patient is choking and unable to speak, the appropriate immediate action is to administer back blows followed by abdominal thrusts, as this method is designed to dislodge the object causing the obstruction in the airway.

Back blows involve striking the patient between the shoulder blades with sufficient force to create a pressure wave in the airway, which can help to expel the foreign body. If the obstruction is not cleared after five back blows, the procedure is followed by five abdominal thrusts (often known as the Heimlich maneuver), which involves compressing the abdomen to create an upward pressure that can push the object out of the airway.

In this situation, providing water is ineffective and could potentially worsen the choking by introducing a fluid that might further restrict the airway. Asking the patient to cough is also not advisable as they are already unable to speak, indicating a severe obstruction. Performing CPR immediately is reserved for situations where the patient becomes unresponsive and shows no signs of life, rather than the initial steps for an active choking situation.