Fundamentals of First Aid – Choking
Download Instructor-Led Material
What’s at Stake?
Choking occurs when a foreign object lodges in the throat or windpipe, blocking the flow of air. In adults, a piece of food often is the culprit. Young children often swallow small objects. Because choking cuts off oxygen to the brain, first aid must be given as quickly as possible.
What’s the Danger?
When someone is choking with a completely blocked airway, no oxygen can enter the lungs. The brain is extremely sensitive to this lack of oxygen and begins to die within four to six minutes. It is during this time that first aid must take place. Irreversible brain death occurs in as little as 10 minutes.
How to Protect Yourself
- Determine if there is a choking emergency. Common signs of choking include:
- Hands clutched to the throat.
- Inability to talk.
- Difficulty breathing or noisy breathing.
- Trying to cough, but unable to cough forcefully.
- Skin, lips and nails turning blue or dusky.
- Loss of consciousness.
- Stay safe
- Call 911, 1st in an emergency.
- Assess the scene.
- Proceed with care only if it’s safe to do so.
- Keep coughing
- If the person can cough, this should be encouraged. They may manage to clear the obstruction themselves.
- Reassure them and encourage them to pause in their coughing for a count of 3 and then cough again-this increases the pressure behind the cough.
- Know the 5 and 5
- Give 5 back blows. First, deliver five back blows between the person’s shoulder blades with the heel of your hand.
- Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).
- Alternate between 5 blows and 5 thrusts until the blockage is dislodged.
- Do back blows correctly
- Stand to the side of the person.
- Lean them forward.
- Using the heel of your hand, give five forceful back blows between the shoulder blades.
- Each back blow should be a separate attempt to get the object out.
- Abdominal thrusts (the Heimlich Maneuver) on a choking victim.
- Stand behind the person and wrap your arms around their waist and tip the person forward slightly.
- Make a fist with one hand and position it slightly above the person’s navel.
- Grasp the fist with the other hand and press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
- Perform a total of 5 abdominal thrusts, if needed.
- The blockage still isn’t dislodged, repeat the five-and-five cycle.
- You’re the only rescuer, perform back blows and abdominal thrusts before calling 911.
- Another person is available, have that person call for help while you perform first aid.
- The person becomes unconscious, perform standard CPR with chest compressions and rescue breaths.
- Helping a choking and unconscious person
- Lower the person on his or her back onto the floor and clear the airway.
- If a blockage is visible at the back of the throat or high in the throat, reach a finger into the mouth and sweep it out.
- Be careful not to push the food or object deeper into the airway, which can happen easily in young children.
- Begin cardiopulmonary resuscitation (CPR) if the object remains lodged and the person doesn’t respond after you take the above measures.
- The chest compressions used in CPR may dislodge the object.
- Remember to recheck the mouth periodically.
- Are you choking?
- Perform abdominal thrusts (Heimlich maneuver) on yourself.
- Call 911 or your local emergency number immediately.
- Place a fist slightly above your navel.
- Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
- Shove your fist inward and upward.
- Assisting a pregnant or obese person who is choking
- Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.
- Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.
- Repeat until the food or other blockage is dislodged or the person becomes unconscious.
- Clear an infant’s airway (under age 1)
- Sit down with the child and hold the infant face down on your forearm, which is resting on your thigh.
- Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object.
- Hold the infant faceup on your forearm with the head lower than the trunk if the above doesn’t work.
- Using two fingers placed at the center of the infant’s breastbone, give five quick chest compressions.
- Repeat the back blows and chest thrusts if breathing doesn’t resume. Call for emergency medical help.
- Begin infant CPR if one of these techniques opens the airway but the infant does not resume breathing.
- If the child is older than age 1, give abdominal thrusts only.
Being around someone who is choking is a dramatic and scary event. Stay calm and always call 911 for help. It doesn’t matter if your first aid works, the person will still benefit from being checked out by a paramedic.