Choking: First aid (2024)

A step-by-step guide explaining what to do in a choking emergency.

By Mayo Clinic Staff

Overview

First aid for a choking person

First aid for a choking person

Choking: First aid (1)

First aid for a choking person

If a person is choking and cannot talk, cry or laugh forcefully, give five back blows and then five abdominal thrusts.

How to perform abdominal thrusts, also called the Heimlich maneuver, on yourself

How to perform abdominal thrusts, also called the Heimlich maneuver, on yourself

Choking: First aid (2)

How to perform abdominal thrusts, also called the Heimlich maneuver, on yourself

To perform abdominal thrusts, also called the Heimlich maneuver, on yourself, place a fist slightly above your navel. Grasp your fist with the other hand and bend over a hard surface. Shove your fist inward and upward.

Choking happens when an object lodges in the throat or windpipe blocking the flow of air. In adults, a piece of food is usually to blame. Young children often choke on small objects. Choking is life-threatening. It cuts off oxygen to the brain.

Give first aid as quickly as possible if you or someone else is choking. To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course.

When to seek emergency help

If you're the only rescuer, give back blows and abdominal thrusts first. Then call 911 or your local emergency number for help. If another person is there, have that person call for help while you give first aid.

If you're alone and choking, call 911 or your local emergency number right away. Then, give yourself abdominal thrusts, also called the Heimlich maneuver, to remove the stuck object.

Symptoms

Watch for these signs of choking:

  • One or both hands clutched to the throat.
  • A look of panic, shock or confusion.
  • Inability to talk.
  • Strained or noisy breathing.
  • Squeaky sounds when trying to breathe.
  • Cough, which may either be weak or forceful.
  • Skin, lips and nails that change color turning blue or gray.
  • Loss of consciousness.

Treatment

Infant

To clear the airway of a choking infant younger than age 1:

  • Sit and hold the infant facedown on your forearm. Rest your forearm on your thigh. Hold the infant's chin and jaw to support the head. Place the head lower than the trunk.
  • Thump the infant gently but firmly five times on the middle of the back. Use the heel of your hand. Point your fingers up so that you don't hit the back of the infant's head. Gravity and the back thumps should release the blockage.
  • Turn the infant faceup on your forearm if breathing hasn't started. Rest your arm on your thigh. Place the infant's head lower than the trunk.
  • Give five gentle but firm chest compressions with your fingers. Place two fingers just below the nipple line. Press down about 1 1/2 inches. Let the chest rise between each compression.
  • Repeat the back thumps and chest compressions if breathing doesn't start. Call for emergency medical help.
  • Begin infant CPR if the airway is clear but the infant doesn't start breathing.

Child and adult

If a choking person can cough forcefully, let the person keep coughing.

Coughing might naturally remove the stuck object.

If a person can't cough, talk, cry or laugh forcefully, give first aid to the person.

The American Red Cross recommends the following steps:

  • Give five back blows. Stand to the side and just behind a choking adult. For a child, kneel down behind. Place your arm across the person's chest to support the person's body. Bend the person over at the waist to face the ground. Strike five separate times between the person's shoulder blades with the heel of your hand.
  • Give five abdominal thrusts. If back blows don't remove the stuck object, give five abdominal thrusts, also known as the Heimlich maneuver.
  • Alternate between five blows and five thrusts until the blockage is dislodged.

Some sources only teach the abdominal thrust. It's OK not to use back blows if you haven't learned the back-blow technique. Both approaches are acceptable for adults and children older than age 1.

To give abdominal thrusts to someone else:

  • Stand behind the person. For a child, kneel down behind. Place one foot slightly in front of the other for balance. Wrap your arms around the waist. Tip the person forward slightly.
  • Make a fist with one hand. Put it just above the person's navel.
  • Grasp the fist with the other hand. Press into the stomach, also called the abdomen, with a quick, upward thrust — as if trying to lift the person up. For a child, use gentle yet firm pressure to avoid damaging the internal organs.
  • Give five abdominal thrusts. Check if the blockage has been removed. Repeat as needed.

If you're the only rescuer, give back blows and abdominal thrusts first. Then call 911 or your local emergency number for help. If another person is there, have that person call for help while you give first aid.

If the person becomes unconscious, start standard cardiopulmonary resuscitation (CPR) with chest compressions and rescue breaths.

To clear the airway of an unconscious person:

  • Lower the person onto the floor, with the back on the floor and arms to the sides.
  • Clear the airway. If you can see the object, reach a finger into the mouth to sweep out the object. Never finger sweep if you can't see the object. You risk pushing the blockage deeper into the airway. This is very risky with young children.
  • Begin CPR if the person still doesn't respond. If the airway is still blocked, use chest compressions such as those that are used in CPR to remove the stuck object. Only use two rescue breaths per cycle. Recheck the mouth regularly for the object.

Pregnant person or someone you can't get your arms around

If the person is pregnant or if you can't get your arms around the stomach, give chest thrusts:

  • Put your hands at the base of the breastbone, just above the joining of the lowest ribs.
  • Press hard into the chest with a quick thrust. This is the same action as the Heimlich maneuver.
  • Repeat until the blockage is removed from the airway.

Yourself

If you're alone and choking:

Call 911 or your local emergency number right away. Then, give yourself abdominal thrusts, also called the Heimlich maneuver, to remove the stuck object.

  • Place a fist slightly above your navel.
  • Grasp your fist with the other hand.
  • Bend over a hard surface. A countertop or chair will do.
  • Shove your fist inward and upward.

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May 24, 2024

  1. American Red Cross Training Services. Choking. In: First Aid/CPR/AED Participant's Manual. The American Red Cross; 2021. https://www.redcross.org/store/first-aid-cpr-aed-participants-manual/754100.html. Accessed Aug. 22, 2022.
  2. Auerbach PS, et al., eds. Field Guide to Wilderness Medicine. 5th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Aug. 25, 2022.
  3. Ruiz FE. Airway foreign bodies in children. https://www.uptodate.com/contents/search. Accessed Aug. 25, 2022.
  4. AskMayoExpert. Stridor emergency assessment. Mayo Clinic; 2021.
  5. Shepherd W. Airway foreign bodies in adults. https://www.uptodate.com/contents/search. Accessed Aug. 25, 2022.
  6. Moll V. Airway establishment and control. Merck Manual Professional Version. https://www.merckmanuals.com/professional/critical-care-medicine/respiratory-arrest/airway-establishment-and-control. Accessed Aug. 25, 2022.
  7. Tintinalli JE, et al., eds. Resuscitation of children. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw Hill; 2020. https://accessmedicine.mhmedical.com. Accessed Aug. 25, 2022.

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Choking: First aid (2024)

FAQs

What are the basic steps of first aid for choking? ›

Strike five separate times between the person's shoulder blades with the heel of your hand. Give five abdominal thrusts. If back blows don't remove the stuck object, give five abdominal thrusts, also known as the Heimlich maneuver. Alternate between five blows and five thrusts until the blockage is dislodged.

What is the first aid practice for choking? ›

Common questions about first aid for someone who is choking

If back blows do not dislodge the blockage, stand behind them, join your hands around their tummy and form a fist. Pull your hands sharply inwards and upwards. Repeat up to five times. This is sometimes called the Heimlich manoeuvre or abdominal thrust.

What is the first response choking? ›

What is the advised first aid technique for choking? A series of back blows and under-the-diaphragm abdominal thrusts are advised for adults and children over age one year who are choking on a piece of food or a foreign object and are conscious.

What to do if Heimlich doesn't work? ›

If a first attempt fails to dislodge the obstruction, yell for someone to call 911 and then try again. Time is of the essence: After four minutes of oxygen deprivation, permanent brain damage is likely even if the victim is subsequently revived.

How many back blows for choking? ›

Give up to five back blows: hit them firmly on their back between the shoulder blades. If back blows do not dislodge the object, move on to step 2. Back blows create a strong vibration and pressure in the airway, which is often enough to dislodge the blockage. Dislodging the blockage will allow them to breathe again.

What is the best practice for choking? ›

Press hard into the chest with a quick thrust. After each thrust, check if the blockage has been cleared. If the blockage has not cleared after 5 thrusts, continue alternating 5 back blows with 5 chest thrusts, until medical help arrives. If the person becomes blue, limp or unconscious, start CPR immediately.

Do you give breaths to a choking victim? ›

Give two slow, full breaths with a pause in between. If the person's chest does not rise, reposition the head and give two more breaths. If the chest still does not rise, the airway is likely blocked, and you need to start CPR with chest compressions. The compressions may help relieve the blockage.

What to do after Heimlich maneuver? ›

The simple answer is yes you should visit the doctor after choking. Here at Dechoker we like to help people make informed decisions about staying safe. Choking may seem like a quick happenstance, an emergency that's over as abruptly as it started, but its effects can be surprisingly long-lasting.

Why can't you say Heimlich? ›

1) When the American Red Cross introduced back blows to its official guidelines on treating choking, Dr Heimlich disagreed that back blows should be used and asked that his name be removed from the guidelines. Leading to the renaming of the Heimlich manouvre as an Abdominal thrust.

What are the three fundamental manners for chokes? ›

There are three fundamental manners for chokes: compression of the neck-veins which restricts the flow of blood and oxygen to the brain, compression of the trachea,and compression of the chest and the lungs which prevents breathing.

Where do you cut your throat when choking? ›

Description. Emergency airway puncture is done in an emergency situation, when someone is choking and all other efforts to assist with breathing have failed. A hollow needle or tube can be inserted into the throat, just below the Adam's apple (thyroid cartilage), into the airway.

What is the number one priority when someone is choking? ›

First aid for a person choking

Maintaining a clear airway is always the priority to make sure the person can keep breathing. You might need to roll them onto their side, but spinal injury is always a possibility in anyone involved in an accident.

What are 3 common causes of choking 1? ›

Choking can be caused by any of the following:
  • Eating too fast, not chewing food well, or eating with dentures that do not fit well.
  • Drinking alcohol (even a small amount of alcohol affects awareness)
  • Being unconscious and breathing in vomit.
  • Breathing in small objects (young children)
Jan 2, 2023

What is the first thing you ask if you think someone is choking? ›

If you think someone is choking, ask them 'Are you choking?' If they can breathe, speak or cough then they might be able to clear their own throat. If they cannot breathe, cough, or make any noise, then they need your help straight away. Cough it out.

What is the first aid for choking under 1? ›

Chest thrusts for children under 1 year
  1. Lay your baby face up along the length of your thighs.
  2. Find the breastbone and place 2 fingers in the middle.
  3. Give 5 sharp chest thrusts (pushes), compressing the chest by about a third.

What are the 6 steps to care for an unconscious choking victim? ›

  • Perform a scene survey. Determine unresponsiveness. Open Airway. ...
  • Start chest compressions (30 compressions). Open patient's airway and give 1 ventilation. ...
  • Attempt to ventilate. If air does not go in, continue CPR sequence of 30 compressions and 2 ventilations.

What is the first aid for water choking? ›

Place a fist slightly above the navel but below the ribcage. Grab your fist with your other hand. Give quick, upward thrusts into the abdomen. The goal is to force the water and any obstructing material out of the airway.

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