What is the first step in treating choking in an adult?

The first step in treating choking in an adult is to encourage them to cough if they can. Coughing is the body's natural reflex to clear the airway and can often successfully expel the obstruction without the need for more invasive techniques. If a person is able to cough, it indicates that they still have some airflow and the ability to generate force to clear the object. Supporting this natural reflex can be the most effective initial action.

Calling for help, performing abdominal thrusts, or giving back blows should only be considered if the person is unable to cough, speak, or breathe, indicating that they are experiencing severe choking or complete airway obstruction. In those cases, more aggressive measures would then be necessary. However, initiating the response by encouraging coughing when it's possible is the safest and most effective first approach.