Choking: What You Need to Do

CPR, back blows, and the Heimlich maneuver may help if a person you are with is choking. If you are choking, call 911 and attempt to dislodge the obstruction with abdominal thrusts. Choking occurs when an object partially or completely obstructs a person’s airway. Someone who is choking may exhibit the following signs:

• sudden cough
• wheezing
• difficulty breathing
• shortness of breath
• bluish tinge to the skin

This article will explain what to do if you or someone you are with is choking.

If someone you are with is choking, you should call emergency services. While waiting for them to arrive, try CPR, back blows, or the Heimlich maneuver.

Back blows can help children and infants who have an object blocking their airway. The National Safety Council offers the following instructions:

1. Lay the infant face down. Hold their head in one hand with their torso on your forearm against your thigh.
2. Perform up to five back blows between the child’s shoulder blades with the heel of your other hand.
3. If this does not help expel the object, roll the infant face up, supporting the back of the infant’s head with your hand.
4. Position two fingers on the child’s breastbone, just under their nipple line.
5. Perform five chest thrusts by applying pressure on the breastbone, about one per second and 1.5 inches (in) deep.
6. Continue cycles of five back blows and five chest thrusts until the object is expelled or the infant becomes unresponsive.
7. If the infant becomes unresponsive or is found unresponsive, begin CPR.

The National Safety Council gives simple step-by-step instructions on how to perform CPR on someone. It can be slightly different depending on the age of the person you are with.

If the adult or child is not breathing or only gasping, you can take the following steps:

1. Straighten your arms and place one hand on the other in the center of the person’s chest.
2. Give 30 quick chest compressions straight down, aiming for a depth of 2 in for each one. Perform this at a rate of at least 100 compressions per minute. Make sure the chest is rising completely after each compression.
3. Continue this cycle of 30 compressions until the person wakes up, someone can use a defibrillator, or emergency services have arrived.

If the infant or child is not breathing or only gasping, follow these steps:

1. For infants under the age of 1, place two fingers of one hand just underneath the nipple line. For older children, place one or two hands in the center of their chest.
2. Give 30 quick chest compressions, letting the chest rise completely after each compression. For infants, press down one-third of the chest depth. Keep a rate of 100 compressions per minute.
3. Continue this cycle of 30 compressions until the person wakes up, someone can use a defibrillator, or emergency services have arrived.

Learn more about CPR.

Experts do not suggest the Heimlich maneuver for children under 1 year.

For an adult or older child, encouraging them to cough might help expel the object blocking their airway. If this does not work, let them know you are about to perform abdominal thrusts. Take the following steps to perform the Heimlich maneuver:

1. Position yourself to stand behind the person with one leg forward between their legs. If you are helping a child, move yourself down to their height and keep your head to one side of them.
2. Reach around their abdomen and locate their navel.
3. Place the thumb side of your fist against the abdomen just above their navel.
4. Clasp your fist with your other hand. With quick, jerking movements, thrust inward and upward into the person’s abdomen.
5. Continue giving these thrusts until the person expels the object or becomes unresponsive.
6. Even after choking stops, seek immediate medical attention.

If the person is pregnant, or you cannot get your arms around them, do not give them the abdominal thrusts of the Heimlich maneuver. Instead, give chest thrusts from behind by clasping your arms together at their breastbone. Thrust in the same quick, jerking movements on the breastbone to avoid abdominal trauma. Avoid squeezing their ribs with your arms.

If you begin choking, seek help as soon as possible.

This may involve alerting people around you. They should then call emergency services and perform emergency first aid, such as the Heimlich maneuver.

Sometimes, forceful coughs or striking your own chest can help dislodge an item that is blocking your airways. However, your priority should be alerting someone around you for help.

To perform the Heimlich maneuver on yourself, you can:

1. Make a fist with one hand, with your thumb pressed between your navel and rib cage.
2. Place your other hand on top of that hand.
3. Push quickly and forcefully directly into your abdomen.

Firstly, should always alert emergency services to a choking incident, especially for an infant.

If a child younger than 1 year is choking, follow these steps to alternate back blows and chest thrusts:

1. Lay their head on your leg.
2. Strike the center of their back five times with the heel of your hand.
3. Position two fingers on the child’s breastbone, just under their nipple line.
4. Perform five chest thrusts, about one per second, about 1.5 in deep.

If this does not work, follow these steps to perform CPR on the infant:

1. Place one or two hands in the center of the infant’s chest.
2. Give 30 quick chest compressions, letting the chest rise completely after each compression. Press down one-third of the depth of the infant’s chest. Maintain a rate of 100 compressions per minute.
3. Continue this cycle of 30 compressions until the infant wakes up, someone can use a defibrillator, or emergency services have arrived.

Learn when to take a child to urgent care rather than the ER.

According to Safe Kids Worldwide, the following tips can help prevent episodes of choking in children and infants:

• Cut food into smaller pieces.
• Ensure children eat in a chair or high chair rather than while playing or lying down.
• Put yourself at your child’s height and notice any objects within their reach that should not be.
• Keep all small items out of sight and reach, including magnets that may be part of another toy.
• Keep cords and strings out of sight and reach. This includes strings tied to pacifiers, bibs, or toys.
• Make sure the child’s clothing does not contain small items or cords, including when they are sleeping.
• Ensure all toys are appropriate for the child’s age.

The first thing you should do if anyone is choking is alert the emergency services.

You should not attempt to perform the abdominal thrusts the Heimlich maneuver requires. Instead, give chest thrusts from behind.

However, avoid squeezing the person’s ribs with your arms.

Learn what to know for the ninth month of pregnancy.

You should contact emergency services as soon as you notice someone choking.

Even if you successfully remove the object blocking their airways, the person will still require a medical examination.

If the person becomes unresponsive or loses consciousness, first alert emergency services.

Next, lower the person to the ground, expose their chest, and begin performing CPR.  Open their mouth to look inside and remove any objects you can see. To perform CPR:

1. Tilt their head and lift their chin to help open their airway.
2. Compress the person’s chest 30 times, about 2 in deep. Do this at a rate of at least 100 per minute while counting aloud.
3. Continue this cycle of 30 compressions until the person wakes up, someone can use a defibrillator, or emergency help arrives.

Learn about asphyxiation.

If you or someone you are with is choking, the first step is to alert emergency services. Even if you can dislodge the item causing the choking, the person will still need medical evaluation.

While medical services arrive, even people without training can help and potentially save the life of someone choking. Methods to help a person choking include black blows, CPR, and the Heimlich maneuver.

Make sure you have proofed your home and environment to help prevent choking in small children.