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First Aid Basics - Choking

Choking Emergency: Know What to Do

A choking emergency can become life-threatening within minutes. Knowing how to recognize choking and respond quickly can save a life.

This blast is about what to do in ADULT choking situations, not for babies.


How to Recognize Choking

A person with a severe airway blockage may:

  • Be unable to speak, cough, or breathe

  • Make little or no sound

  • Clutch their throat (the universal choking sign)

  • Appear panicked or distressed

  • Have blue or gray lips, face, or fingernails

  • Become unconscious if the blockage is not removed

Important: If the person is coughing forcefully or able to speak, encourage them to keep coughing. Do not interfere unless their condition worsens. Coughing is often the body's most effective way to clear the airway.


What To Do for a Conscious Adult Who Is Choking

Step 1: Call for Help

  • If another person is nearby, have them call 911 immediately.

  • If you are alone with the victim, begin care first and then call 911 if the object is not quickly removed.


Step 2: Give 5 Back Blows

  1. Stand slightly behind and to the side of the person.

  2. Support their chest with one arm.

  3. Bend them forward at the waist so the object is more likely to come out rather than move deeper into the airway.

  4. Using the heel of your hand, deliver 5 firm back blows between the shoulder blades.


Step 3: Give 5 Abdominal Thrusts

If the object is not expelled after the back blows:

  1. Stand behind the person.

  2. Place a fist just above the navel and below the breastbone.

  3. Grasp your fist with your other hand.

  4. Deliver 5 quick inward and upward thrusts.


Step 4: Repeat

Continue alternating:

  • 5 back blows

  • 5 abdominal thrusts

until:

  • The object comes out,

  • The person can breathe, cough, or speak, or

  • The person becomes unresponsive.

    • Remove the object only if you can clearly see it.

      Do not perform blind finger sweeps. Reaching into the mouth when you cannot see the object may push it deeper into the airway.


When to Call 911

Call 911 immediately if:

  • The person cannot speak, cough, or breathe.

  • The blockage is not quickly removed.

  • The person becomes unconscious.

  • You are unsure whether the airway is fully clear.

If someone else is present, have them call while you provide aid.


Special Situations

Pregnant Individuals or Larger Adults

If you cannot effectively perform abdominal thrusts, use chest thrusts instead. Place your hands on the center of the chest, just above where the lower ribs meet, and deliver quick inward thrusts.


If You are Alone

You can self-perform the abdominal thrusts.

Give yourself abdominal thrusts:

  • Place your fist above your naval

  • Grasp your fist with your other hand

  • Shove your first inward and upward.

Or you can use a hard surface, like a chair, by bending over the back and thrusting it above your naval.


Safety Takeaway

Current first-aid guidance recommends 5 back blows followed by 5 abdominal thrusts for a conscious choking adult who cannot cough, speak, or breathe. Acting quickly and calling 911 when needed can make the difference between life and death. Consider taking a certified First Aid/CPR course to practice these lifesaving skills before an emergency occurs.


Watch it in Action:

This video shows the back blow & Heimlich actions well (starting at 0:45).

Of note, they are British and calling 999/112 - here obviously call 911!



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