What to Do When Someone is Choking: A Guide

Choking occurs when an object or piece of food blocks the airway, preventing airflow and making it difficult or impossible for a choking person to breathe. Quick action is crucial, as choking can become life-threatening within minutes. Recognizing the signs of choking helps determine the appropriate response.

Signs of Severe Choking

• Inability to speak, cough, or breathe.

• Clutching the throat with both hands (universal choking sign).

• Wheezing or high-pitched sounds while trying to inhale.

• Bluish skin, lips, or fingernails due to lack of oxygen.

• Loss of consciousness if the obstruction is not cleared.

Assessing the Situation and Calling for Help

When someone is choking, it’s essential to assess the situation quickly and call for help if necessary. Here are some steps to follow:

1. Check for signs of choking: Look for signs such as difficulty speaking or making sounds, coughing or gagging, inability to breathe or speak, blue-tinged skin or lips, or loss of consciousness.

2. Ask the person if they are choking: If the person is conscious, ask them if they are choking. If they are unable to speak, look for other signs of choking.

3. Call for emergency medical help: If the person is choking and you are alone, call 911 or your local emergency number right away. If someone else is present, have them call for help while you give first aid.

4. Provide first aid: While waiting for emergency medical help to arrive, provide first aid by performing abdominal thrusts (also known as the Heimlich maneuver) or back blows.

Immediate Actions for Choking Victims

For Conscious Adults and Children Over One Year Old

1. Encourage Coughing – If the person can still cough or breathe, encourage them to keep coughing forcefully to clear the blockage. Do not interfere unless the choking worsens.

2. Perform the Heimlich Maneuver (Abdominal Thrusts) – If the person cannot breathe or speak, perform abdominal thrusts by taking the following steps:

• Stand behind the person and wrap your arms around their waist.

• Make a fist and place it just above the navel.

• Grasp your fist with your other hand and give quick, upward thrusts.

• Repeat until the object is expelled or the person becomes unconscious.

3. Call Emergency Services – If the obstruction does not clear within a few attempts, seek medical assistance immediately.

For Choking Infant (Under One Year Old)

1. Back Blows – Hold the choking infant face down along your forearm, supporting the head and neck. Deliver five firm back blows between the shoulder blades using the heel of your hand.

2. Chest Thrusts – Turn the choking baby onto their back while keeping their head lower than the chest. Place two fingers in the center of the chest and give five gentle, but firm, thrusts.

3. Repeat Until the Object is Dislodged – Continue alternating back blows and chest thrusts until the airway is cleared or emergency help arrives.

If the Person Becomes Unconscious

1. Call Emergency Services Immediately.

2. Begin CPR if There is No Breathing. If the airway remains blocked, start chest compressions followed by rescue breaths.

3. Check the Person's Mouth – If you can see the object, carefully remove it, but avoid blindly sweeping the mouth as this may push it deeper.

Special Considerations for Choking

There are some special considerations to keep in mind when dealing with choking:

1. Pregnant or obese people: For pregnant or obese people, chest thrusts may be more effective than abdominal thrusts. To perform chest thrusts, place the heel of one hand on the center of the person’s chest, and push down on the chest with the heel of your hand to a depth of about 1/4 inch.

2. Infants and young children: For infants and young children, back blows and chest thrusts may be more effective than abdominal thrusts. To perform back blows, sit the child up and support their head and neck. Use the heel of your hand to give five quick blows between the child’s shoulder blades.

3. People with disabilities: For people with disabilities, such as those with spinal cord injuries, special care may be needed to ensure their safety during first aid.

Cardiopulmonary Resuscitation (CPR) and Choking

If a person is choking and becomes unresponsive, cardiopulmonary resuscitation (CPR) may be necessary. Here are some steps to follow:

1. Check for breathing and pulse: Check the person’s airway, breathing, and circulation (ABCs). If the person is not breathing or has no pulse, begin CPR.

2. Perform CPR: Perform CPR by giving 30 chest compressions followed by two breaths. Continue this cycle until emergency medical help arrives.

3. Use an automated external defibrillator (AED): If the person is in cardiac arrest, use an AED if available.

Preventing Choking Incidents

• Cut food into small, manageable pieces, especially for young children.

• Avoid giving small, round, or hard foods (e.g., nuts, grapes, hard candy) to toddlers.

• Chew food slowly and avoid talking or laughing while eating.

• Keep small objects out of reach of infants and young children.

• Encourage safe eating practices and avoid distractions during meals.

Emergency Help and Follow-up Care

After providing first aid for choking, it’s essential to seek emergency medical help and follow up with proper care:

1. Seek emergency medical help: Even if the person appears to be okay after first aid, seek emergency medical help to ensure that the airway is clear and there are no other complications.

2. Follow up with medical care: After emergency medical help has been provided, follow up with medical care to ensure that the person receives any necessary treatment or follow-up care.

3. Learn first aid: Learning first aid, including CPR and the Heimlich maneuver, can help you prepare for choking emergencies and save lives.

Conclusion

Choking can be a life-threatening emergency, but knowing how to respond quickly can save a life. Recognizing choking signs, performing the Heimlich maneuver, and providing proper first aid to infants and adults are essential skills. Taking precautions to prevent choking, especially for children and older adults, can help reduce the risk of these dangerous incidents.

FAQs

What should I do if I am alone and choking?

Try performing abdominal thrusts on yourself by leaning over a firm surface, such as a chair or counter, and pressing forcefully against your abdomen.

Can back blows be used on adults?

Back blows are generally recommended for infants, but they may be used on adults if abdominal thrusts are ineffective.

When should I stop performing abdominal thrusts?

Stop once the object is expelled, the person begins breathing normally, or emergency responders take over.

Is it safe to perform the Heimlich maneuver on pregnant individuals?

For pregnant individuals, place your hands higher on the chest, just above the baby bump, and perform chest thrusts instead of abdominal thrusts.

How can I tell if someone is choking or having a different medical emergency?

Choking victims typically cannot speak, cough, or breathe. If they can still make sounds, they may be in distress but not completely choking.