What are the steps to help a person who is choking?

Life-Saving Knowledge: Step-by-Step Guide to Helping a Choking Person

Choking is when food or another object gets stuck in the airway in the throat. The object can block the airway and stop air from getting in the lungs. In adults, choking is often caused by food. In children, choking can be caused by food or another object.

The block in the airway that causes choking can be either mild or severe. If the airway block is severe, act quickly. Get the object out so that the person can breathe.

Primary Assessment: Mild vs Severe Airway Block

Here is how to assess if someone has a mild or severe airway block and what you should do.

Mild Airway block

• If someone:
  • Can talk or make sounds
  • Can cough loudly
• Then take the following actions:
  • Stand by and let the person cough
  • If you're worried about the person's breathing, phone your local emergency number.

Severe airway block

• If someone:
  • Cannot breathe, talk, or make sound or
  • Has a cough that has no sound or
  • Makes the choking sign, which is holding the neck with one or both hands.
• Then take the following actions:
  • Act quickly
  • Follow the steps to help an adult, child, or infant with a severe airway block

How to Help a Choking Adult or Child with a Severe Block

When an adult or child has a severe airway block, give thrusts slightly above the belly button. These thrusts are called abdominal thrusts or the Heimlich maneuver. Like a cough, each thrust pushes air from the lungs. This can help move or remove an object that is blocking the airway.

Any person who has received abdominal thrusts for choking should see a healthcare provider as soon as possible.

Follow these steps to help a choking adult or child who has a severe airway block:

1. If you think someone is choking, ask: "Are you choking? Can I help you?"
2. If the person nods yes, tell him you are going to help.
3. Stand firmly or kneel behind the person (depending on your size and the size of the person choking). Wrap your arms around the person's waist so that your fists are in front.
4. Make a fist with one hand.
5. Put the thumb side of your fist slightly above the belly button and well below the breastbone.
6. Grasp the fist with your other hand and give quick upward thrusts into the abdomen.
7. Give thrusts until the object is forced out and the person can breathe, cough, or speak, or until he becomes unresponsive

How to Help a Choking Pregnant Woman or a Large Person with a Severe Airway Block

If the person who has a severe airway block is pregnant or very large, give chest thrusts instead of abdominal thrusts.

Follow these steps to help a pregnant woman or a large adult or child who has a severe airway block.

1. If you can't wrap your arms fully around the waist, give thrusts on the chest (chest thrusts) instead of on the abdomen.
2. Put your arms under the armpits and your hands on the lower half of the breastbone.
3. Pull straight back to give chest thrusts.

How to Help a Choking Infant with a Severe Airway Block

When an infant has a severe airway block, use back slaps and chest thrusts to help remove the object. Give only back slaps and chest thrusts to an infant who is choking. Giving thrusts to an infant's abdomen can cause serious harm.

Follow these steps to help an infant who has a severe airway block:

1. Hold the infant facedown on your forearm. Support the infant's head and jaw with your hand.
2. Give up to 5 back slaps with the heel of your other hand, between the infant's shoulder blades.
3. If the object does not come out after 5 back slaps, turn the infant onto his back, supporting the head.
4. Give up to 5 chest thrusts, using 2 fingers of your other hand to push on the chest in the same place you push during CPR.
5. Repeat giving 5 back slaps and 5 chest thrusts until the infant can breathe, cough, or cry, or until he becomes unresponsive.

How to Help a Choking Adult who Becomes Unresponsive

If you can't remove the object blocking the airway, the person will become unresponsive. Always give CPR to anyone who is unresponsive and not breathing normally or only gasping.

Follow these steps to help an adult with a severe airway block who becomes unresponsive:

1. Shout for help
2. Phone or have someone else phone your local emergency number and get an AED. Put the phone on speaker mode so that you can talk to the dispatcher.
3. Provide CPR, starting with compressions.
4. After each set of 30 compressions, open the airway to give breaths.
5. Look in the mouth (back of the throat). If you see an object in the mouth, take it out. Do not perform a blind finger sweep, this could cause the object to get lodged further back in the airway.
6. Give 2 breaths and then repeat 30 compressions.
7. Continue CPR until
   • The person moves, speaks, blinks, or otherwise reacts.
   • Someone with more advanced training arrives and takes over.

How to Help a Choking Child or Infant who Becomes Unresponsive

A child or an infant who has a severe airway block and becomes unresponsive needs immediate CPR. If you are alone without a cell phone, it is important to provide 5 sets of 30 compressions and 2 rescue breaths first. Then, leave the child to phone your local emergency number and get an AED if one is available.

Follow these steps to help a child or infant with a severe airway block who becomes unresponsive:

1. Shout for help. Make sure the child or infant is lying on his back on a firm flat surface.
2. Begin CPR, phone your local emergency number, and get an AED.
   • If someone comes to help and a cell phone is available
     • Ask the person to phone your local emergency number on the cell phone, put it on speaker mode, and go get an AED while you begin CPR.
   • If someone comes to help and a cell phone is not available
     • Ask the person to phone your local emergency number and go get an AED while you begin CPR.
   • If you are alone and do have a cell phone or nearby phone
     • Phone your local emergency number and put the phone on speaker mode while you begin CPR.
     • Give 5 sets of 0f compressions and 2 breaths.
     • Go get an AED.*
     • Return to the child or infant and continue CPR.
   • If you are alone and don't have a cell phone
     • Give 5 sets of 30 compressions and 2 breaths.
     • Phone your local emergency number and get an AED.*
     • Return to the child or infant and continue CPR.
3. Provide CPR
   • Give sets of 30 compressions and 2 breaths
   • After each set of 30 compressions, open the airway to give breaths.
   • Look in the mouth. If you see an object in the mouth, take it out. Do not perform a blind finger sweep. This could cause the object to get lodged further back in the airway.
   • Give 2 breaths
4. Continue CPR and looking in the mouth after each set of compressions until:
   • The child or infant moves, cries, speaks, blinks, or otherwise reacts.
   • Someone with more advanced training arrives and takes over.