Choking First Aid: Learn Life-Saving Techniques to Respond in Emergencies

Last updated:
May 30, 2023

Choking incidents are more common than we realize and can turn into life-threatening emergencies in the blink of an eye. Whether it happens while eating, playing, or just talking, choking poses serious risks to our well-being. The consequences can be severe, even fatal if immediate action is not taken. That's why knowing the right first aid techniques is so important. It can be the key to saving lives and providing crucial help when it's needed the most. In this article, we'll explore simple and effective first aid techniques that anyone can learn to respond confidently in choking emergencies.


What Is Choking?

Choking refers to a situation in which the airway is partially or completely blocked, hindering the normal flow of air to the lungs. It occurs when a foreign object, such as food, a small toy, or another item, becomes lodged in the throat or windpipe. This obstruction prevents the person from breathing properly and can lead to a life-threatening emergency if not addressed promptly.

Within a matter of minutes, the brain and other vital organs may be deprived of oxygen, leading to brain damage or even death. Infants, young children, and older adults are particularly vulnerable to choking incidents, making it essential for individuals of all ages to be aware of the potential risks and equipped with the necessary first aid knowledge.


What are the Common Signs and Symptoms of Choking?

When someone is choking, there are several signs and symptoms that may indicate an obstruction in the airway. Recognizing these common indicators is crucial for identifying a choking emergency and initiating the appropriate response. Here are the typical signs and symptoms of choking:

  • Difficulty Breathing
  • Coughing or Wheezing
  • Inability to Speak
  • Clutching the Throat
  • Panic or Agitation
  • Discoloration or cyanosis
  • Loss of Consciousness for severe choking cases 

What To Do When Someone Is Choking

First aid plays a critical role in choking incidents, empowering bystanders to take swift action before professional help arrives. Knowing the proper techniques and being able to apply them in a calm and efficient manner can make a life-or-death difference. By understanding and practicing first aid for choking, individuals can become invaluable first responders in these challenging situations.


Upon recognizing a choking incident, what are the immediate steps to take?

Upon recognizing a choking incident, it is crucial to take immediate action to assist the choking individual. Here are the immediate steps to take when someone is choking:

  1. Assess the Severity: Quickly assess the severity of the choking situation. Determine if the person can cough, speak, or breathe partially, which suggests a partial obstruction. If they can produce any sounds and are able to cough, encourage them to continue coughing forcefully to try to dislodge the object. However, if the person cannot cough, speak, or breathe at all, it indicates a complete blockage and requires immediate intervention.
  2. Provide Support and Reassurance: Stay calm and approach the choking person to offer immediate support. Encourage them to remain upright and reassure them that you are there to help.
  3. Encourage Self-Initiated Coughing: If the person is conscious and able to cough, allow them to continue coughing. Coughing is the body's natural mechanism to dislodge the obstruction. Reinforce the importance of strong coughing to assist in clearing the airway.


At what point should I call for emergency medical help during a choking event?

You should call for emergency medical help as soon as you notice the signs and symptoms of choking. Promptly calling for professional assistance is crucial to ensure timely intervention and increase the chances of a positive outcome. It is better to err on the side of caution and seek emergency help if you are unsure about the severity of the choking incident. Remember, time is of the essence, and getting immediate medical assistance can be life-saving.


Adult and Older Children Choking Relief

Choking is a medical emergency that can happen to anyone, including adults and children over 1 year old. It occurs when a foreign object blocks the airway, making it difficult or impossible to breathe. Choking can be caused by food, small objects, or even vomit. It is important to know the proper techniques to relieve choking, as it can be life-saving.


Signs of a child/adult choking:

  • The patient has both hands wrapped around the base of their throat.
  • The child cannot speak, cry, or provide respiration sounds with complete airway obstruction.
  • The patient may be confused, obtunded, or cyanotic.
  • Partial airway obstruction may allow for a productive cough or for the patient to speak.


If there is partial airway obstruction: Do not attempt the Heimlich maneuver.

If complete airway obstruction:

  • Immediately call the emergency response team.
  • Attempt Heimlich maneuver


What is Heimlich Maneuver?

The Heimlich maneuver is an abdominal thrust technique used to dislodge an obstruction from the airway of a choking person. It is a first aid procedure designed to create pressure within the abdomen, forcing air to expel from the lungs and dislodging the obstructing object. The Heimlich maneuver is commonly performed on adults and older children who are conscious and experiencing a complete blockage of the airway. This technique should only be performed on individuals who are unable to cough, speak, or breathe due to a complete blockage of the airway


To perform the Heimlich maneuver:

  1. Stand behind the choking person and wrap your arms around their waist.
  2. Make a fist with one hand and position the thumb side against the middle of the abdomen, just above the navel.
  3. Grasp your fist with your other hand to provide support and leverage.
  4. Give quick, upward and inward thrusts to the abdomen, using your hands and upper body.
  5. The aim is to apply enough pressure to force air from the lungs and dislodge the obstruction.
  6. Repeat the thrusts until the object is expelled or the person becomes unresponsive.


If the patient becomes unconscious:

  • Initiate CPR.
  • Before attempting rescue breaths during standard CPR, open the airway, and remove any visible obstruction.
  • Do not use a blind finger sweep in an attempt to remove a block.

Under what conditions should I not perform the Heimlich maneuver?

While the Heimlich maneuver is generally considered a safe and effective technique for relieving choking, there are certain situations where it may not be appropriate or advisable to perform it. Here are some circumstances in which the Heimlich maneuver should be avoided:

  1. Pregnancy: The Heimlich maneuver may pose a risk to the fetus or the pregnant person due to the forceful abdominal thrusts involved. It is advisable to encourage seeking immediate medical assistance in such cases.
  2. Obesity: Choking victims with obesity may have altered anatomical structures, and the application of excessive force during the Heimlich maneuver could potentially cause injury. Caution should be exercised, and alternative techniques or professional medical help should be considered.
  3. Abdominal Surgery: Choking victims who have undergone recent abdominal surgery may have surgical incisions or weakened tissues that could be at risk of injury during the Heimlich maneuver. It is essential to exercise caution and consult medical professionals for appropriate guidance.
  4. Known or Suspected Spinal Injury: If there is a possibility of a concurrent spinal injury, forceful abdominal thrusts should be avoided. Stabilizing the person's head and neck and seeking immediate medical assistance is crucial.
  5. Children under One Year Old: The Heimlich maneuver is not recommended for infants under one year old. Instead, techniques such as back blows and chest thrusts are preferred for this age group.
  6. Unconsciousness: If the choking victim is already unconscious, the Heimlich maneuver is not appropriate. Initiate CPR immediately, starting with chest compressions.


Beyond the Heimlich maneuver, what other techniques can be used in choking first aid?

Beyond the Heimlich maneuver, several other techniques can be used in choking first aid, depending on the age of the individual and the severity of the choking episode. Here are some additional techniques:

  • Back Blows: This technique is used for infants under one year old.
  • Chest Thrusts: If back blows are ineffective for an infant, you can perform chest thrusts.
  • Conscious Abdominal Thrusts: This technique is an alternative to the Heimlich maneuver for individuals who are obese, pregnant, or in certain situations where the traditional maneuver is not feasible.
  • Chest Compressions: If the person becomes unresponsive and their airway is still blocked, begin CPR chest compressions.
  • Finger Sweeps: If you can see the object causing the choking and it is easily accessible, you may attempt a finger sweep.

Infant Choking Relief

An infant is choking if he cannot speak, cry, or provide respiration sounds with complete airway obstruction. If signs of choking are present and the infant is conscious: Give 5 back blows and 5 Chest thrusts.

Partial airway obstruction may result in a stridor or a high-pitched noise during respiration. Do not attempt the Heimlich maneuver if the child has a partial airway obstruction, powerful cough, or audible solid cry. The techniques of back blows and chest thrusts techniques are used to help dislodge the obstruction and restore the infant's breathing.

How to Perform Back Blows?

  1. Hold the infant face-down along your forearm, ensuring their head is lower than their chest.
  2. Support the infant's head and neck with your hand while keeping their mouth and nose clear.
  3. Deliver up to five firm back blows between the infant's shoulder blades using the heel of your hand.
  4. Check after each blow to see if the obstruction has been dislodged.
  5. If the obstruction remains, proceed to chest thrusts.


How to Perform Chest Thrusts?

  1. Turn the infant over while supporting their head and neck, so they are now facing upward.
  2. Place two fingers in the center of the infant's chest, just below the nipple line.
  3. Give up to five gentle chest thrusts, pushing inward and upward.
  4. Be careful not to compress the throat or apply too much force.
  5. Check after each thrust to see if the obstruction has been cleared.
  6. Continue alternating between back blows and chest thrusts until the object is expelled or medical help arrives.

If the infant becomes unconscious:

  • Initiate CPR.
  • Before attempting rescue breaths during standard CPR, check the victim's airway, and remove any visible obstruction.
  • Never use a blind finger sweep in an attempt to remove a block.

Is it possible to harm a choking person by overly forceful back blows?

While back blows are generally considered safe and effective for relieving choking in infants and older children, it is important to exercise caution and avoid overly forceful blows. The purpose of back blows is to generate enough force to dislodge the obstruction without causing harm. It is essential to strike the back with enough force to create a strong cough reflex but not so forcefully that it causes injury.


On what basis should I decide whether to perform back blows or abdominal thrusts?

The decision to perform back blows or abdominal thrusts depends on the age and responsiveness of the choking person. For infants and younger children, back blows are the primary technique. If back blows are unsuccessful in dislodging the obstruction, abdominal thrusts should be considered. However, for older children and adults, the Heimlich maneuver (abdominal thrusts) is typically the preferred technique right from the start.


How do I ensure the object causing choking is completely off the airway?

To ensure that the object causing choking is completely cleared from the airway, observe the person's response. If they are able to cough forcefully or speak, encourage them to continue coughing to expel the object. If the person becomes unresponsive, unable to breathe, or the choking persists, it is crucial to seek immediate medical assistance. Medical professionals have the expertise and equipment to ensure the airway is completely clear and provide further treatment, if necessary.


What Should I Do Next If the Choking Victim Becomes Unresponsive?

If the choking victim becomes unresponsive, perform CPR immediately. It is crucial to act quickly and follow these steps:


1. Call for Emergency Medical Assistance

Immediately dial the emergency services number in your country (such as 911 in the United States) to request professional help. Inform the dispatcher that the person is unresponsive and has been choking.


2. Begin CPR (Cardiopulmonary Resuscitation)

Start performing CPR by laying the person on a firm surface. Ensure their airway is clear and open. If you are trained in CPR, begin with chest compressions. Place the heel of your hand on the center of the person's chest (between the nipples) and interlock your fingers. Push down firmly and rapidly at a rate of around 100-120 compressions per minute.


3. Check for Object and Clear if Visible

After 30 compressions, open the airway using the head-tilt, chin-lift technique. Look into the mouth and, if you can see the object causing the choking, remove it with your finger. Do not perform a blind finger sweep as it may push the object further down.


4. Continue CPR

If the object is successfully removed, resume CPR with chest compressions and rescue breaths (if you are trained to do so) in a ratio of 30 compressions to 2 rescue breaths. Follow the guidelines provided by emergency medical services until professional help arrives.

It is important to remain calm and follow proper CPR protocols. If you are not trained in CPR, the emergency dispatcher can guide you through the steps until medical help arrives. Acting promptly and seeking professional assistance is crucial in increasing the chances of a positive outcome for the unresponsive choking victim.


What should I do after the object causing choking has been expelled?

After the object causing choking has been expelled, it is important to seek medical attention to ensure that the airway is completely clear and there are no further complications. In some cases, small pieces of food or objects may remain in the airway, which can lead to infection or inflammation. A healthcare professional may also want to examine the throat and airway to rule out any injuries or damage that may have occurred during the choking episode.

It is also important to monitor the person for any signs of distress or breathing difficulties, especially if they experienced a prolonged period of oxygen deprivation during the choking episode. In some cases, a person may require additional oxygen or respiratory support to help them recover.


How can I maintain calm throughout the process of aiding a choking victim?

Maintaining calm during the process of aiding a choking victim is crucial for both your own well-being and the well-being of the person in distress. To stay composed, take deep breaths to center yourself and focus on the task at hand. Remind yourself of your knowledge and training in first aid, reinforcing your confidence in your abilities. Speak calmly to reassure both yourself and the choking victim, creating a more positive environment.

Remember, staying calm allows you to think clearly and act effectively, ultimately increasing the chances of a successful outcome.


What are the potential complications of choking, even after successful relief?

The potential complications of choking, even after successful relief, can include laryngospasm, vocal cord paralysis, aspiration pneumonia, and hypoxia. Laryngospasm is when the muscles around the vocal cords go into spasm and restrict airway flow. This can often happen when the patient is exposed to cold air during treatment for choking. Vocal cord paralysis occurs when the nerves that control the vocal cords become damaged, and the vocal cords cannot move. Aspiration pneumonia is an infection of the lungs caused by inhaling food, saliva, vomit, or other substances. Hypoxia is a condition in which the brain and other organs are deprived of oxygen.

It is also important to remember that even if the patient appears to be relieved of choking, they may still have underlying medical conditions that could have caused the choking in the first place. A doctor should always be consulted if there are any concerns about a possible underlying health condition.


What are the common choking hazards?

There are various common choking hazards that can pose a risk, especially to young children and infants. Here are some examples:

  • Small food items such as grapes, berries, nuts, popcorn, hot dogs, and candies.
  • Hard or round objects like marbles, small toy parts, buttons, coins, or small batteries.
  • Small toy accessories, like detachable eyes, buttons, or small figurine parts.
  • Uninflated or broken balloon pieces
  • Any small objects, including screws, buttons, safety pins, or small magnets.
  • Household items like bottle caps, pen caps, rubber bands, or small magnets


How to Prevent Choking Incidents?

Preventing choking incidents is crucial, especially when it comes to the safety of young children and infants. Here are some measures you can take to reduce the risk of choking:

  1. Always supervise young children while they eat or play to ensure they do not put small objects or food items in their mouths.
  2. Provide toys that are suitable for the child's age and development stage. Avoid toys with small detachable parts that can be easily swallowed.
  3. Cut food into small, manageable pieces, especially for young children. Avoid serving hard, round, or sticky foods that can be choking hazards.
  4. Keep small objects like coins, buttons, and batteries out of reach of young children. Regularly inspect the play areas to ensure there are no small objects within their grasp.
  5. Encourage children to sit and eat in a calm and quiet environment. Discourage running, playing, or talking with a full mouth to prevent choking.
  6. Teach children to chew their food thoroughly and not to talk or laugh while eating. Encourage them to take small bites and eat slowly.
  7. Learn basic first aid skills, including CPR and choking relief techniques, to be prepared to respond in case of an emergency.
  8. Consider taking a certified CPR and first aid training course. Proper training can equip you with the knowledge and skills needed to respond effectively in choking emergencies.

By implementing these preventive measures and being vigilant, you can significantly reduce the risk of choking incidents and help keep yourself and others safe.


Can I learn choking first aid via online classes?

Yes, you can learn choking first aid through online classes. Many reputable organizations and institutions offer online courses and training programs that cover first aid, including choking relief techniques. These online classes often provide detailed instructional videos, demonstrations, and step-by-step guidance on how to respond to choking emergencies in different age groups.

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