BLS Certification Manual: Choking Procedures for Adults & Children

Procedures for Adults & Children

For a responsive adult or child with a severe airway obstruction, use alternating back blows and abdominal thrusts. Abdominal thrusts for choking are also commonly known as the Heimlich maneuver.

First Aid Steps:

1. Confirm signs of severe choking
2. Call 911 or direct someone else to call
3. Stand to the side and slightly behind the person
4. Give 5 firm back blows between the shoulder blades
5. Give 5 abdominal thrusts
6. Continue alternating 5 back blows and 5 abdominal thrusts
7. Continue until the object is expelled or the person becomes unresponsive

For a child, adjust your position to the child's size while using the same sequence.

Abdominal Thrusts

To perform abdominal thrusts:

1. Stand behind the person
2. Place a fist just above the belly button and below the breastbone, with the thumb side of the fist against the abdomen
3. Grasp the fist with the other hand
4. Deliver quick inward and upward thrusts

Pregnancy or When Abdominal Thrusts Cannot Be Performed

Use chest thrusts instead of abdominal thrusts when abdominal thrusts are not appropriate, such as in later pregnancy or when you cannot effectively encircle the abdomen.

If the Person Becomes Unresponsive

1. Carefully lower the person to a firm surface
2. Begin CPR starting with chest compressions
3. Each time the airway is opened for breaths, look for a visible object
4. Remove an object only if it is clearly visible and easily reachable
5. Do not perform a blind finger sweep
6. Use an AED as soon as available

Remember:  5 back blows → 5 abdominal thrusts