How to Stop Choking

Choking can be caused by failing to chew food well enough before swallowing.

Choking occurs when a person's throat or windpipe is completely or partially blocked, cutting off the air supply. The blockage might be caused by a piece of under-chewed food, or a small toy (in infants). If the victim is unable to give the universal sign for choking -- hands clutched to the throat -- look for other danger signs including ιnability to talk, difficult or noisy breathing, bluish skin color, and weak coughing. Permanent brain damage can occur in as little as four minutes when the brain is starved of oxygen, so first aid should be administered as soon as possible.

Instructions

First Aid for a Choking Adult (Who is Conscious)

1. Establish that the person is indeed choking by asking them. If the person is unable to speak, indicates they are in difficulty, or shows other signs of choking, proceed with first aid.

2. Ask another person to call 911 for help while you perform first aid. If you are alone, begin performing first aid immediately.

3. Stand behind the choking person and deliver five firm blows to the person's back, between the shoulder blades, with the heel of your hand.

4. Wrap your arms around the waist from behind, tipping the person forward slightly.

5. Position a fist slightly above the person's navel.

6. Grasp the fist with your other hand and press hard into the abdomen with a swift, upward thrust movement as if you are trying to lift the person off the ground. This is called the Heimlich maneuver.

7. Repeat the Heimlich maneuver -- as per steps four through six -- up to four more times if necessary.

8. Alternate between five back blows and five abdominal thrusts (Heimlich maneuver) until the blockage is dislodged.

First Aid for a Choking Infant Under 12 Months (Who is Conscious)

1. Sit down and rest your forearm across your thigh. Hold the choking infant face down on your forearm.

2. Thump the infant gently but firmly five times on the middle of the back using the heel of your hand.

3. Hold the infant face up on your forearm with the head positioned lower than the torso.

4. Place two fingers at the center of the infant's breastbone and give five quick chest compressions.

5. Alternate between back blows and chest thrusts until the blockage is dislodged and normal breathing resumes.

Performing the Heimlich Maneuver on Yourself

1. Place a fist slightly above your navel.

2. Grasp your fist with the other hand and bend over a hard surface such as a table, a counter top or a chair.

3. Shove your fist inward and upward.

Tips & Warnings

• Do not perform first aid on a choking person who is coughing forcefully and able to speak. The person may be able to dislodge the blockage with a strong cough. Be ready to act immediately, though, if the symptoms worsen.

• If you and the choking person are alone, try to dislodge the blockage first before calling 911 for help.

• If a choking person loses consciousness, attempt to dislodge the blockage by laying the person on their back and using your finger to sweep out any visible object in the back of their throat. If the object remains lodged, begin CPR chest compressions if you have the appropriate training or ask someone else to perform CPR until help arrives. Chest compressions may help dislodge the blockage.

• Do not give back blows to choking children over the age of one; administer abdominal thrusts only.

• If you are performing the Heimlich maneuver on a pregnant woman or obese person, place your fist on the middle of the breastbone, between the nipples, rather than above the navel.

• Learn the Heimlich maneuver and CPR in a certified first-aid training course. Ask about courses run by the Red Cross, the YMCA, the American Heart Association, schools, or hospitals in your area.

References

• Mayo Clinic: Choking First Aid
• MedlinePlus: Choking - Adult or Child Over 1 Year