First Aid Tips: Choking
Based on a module
by Fred Mednick from the Connexions website’s Health Education
Introduction by Dr. Don Rose, Writer, Life Alert
Periodically reviewing the best way to deal with someone who is choking is always
recommended. This article provides an overview that lets you do such a review. Whether
you can do the Heimlich, or haven’t the slightest idea how to handle it, this
article provides essential and useful information. --Don Rose
If you are working with infants and children, be sure that you keep marbles, beads,
thumbtacks, and other small objects out of their reach and prevent them from walking,
running, or playing with food or toys in their mouths. If you observe a "conscious"
- Ask, "Are you choking?"
- If the victim can speak, cough,
or breathe, DO NOT INTERFERE.
- WebMD.com says “It is best
not to do anything if the person is coughing forcefully and not turning a bluish
- If the victim CANNOT speak, cough,
or breathe, give abdominal thrusts below the diaphragm (the Heimlich maneuver) until
the foreign body is expelled or the victim becomes unconscious. (Note that, in cases
of extreme obesity or late pregnancy, one can give chest thrusts.)
The Heimlich Maneuver for
A choking victim who can't speak or breathe needs help immediately. According to
WebMD.com, “[s]omeone who cannot answer by speaking and can only nod the head
has a complete airway obstruction and needs emergency help. The treatment for a
choking person who begins to turn blue or stops breathing varies with the person's
age. In adults and children older than 1 year,
the Heimlich maneuver should be attempted.”
For cases in which a choking victim cannot speak or breathe, follow these steps:
- From behind, wrap your arms around
the victim's waist.
- Make a fist and place the thumb
side of your fist against the victim's upper abdomen, below the ribcage and above
- Grasp your fist with your other
hand and press into their upper abdomen with a quick upward thrust. Do not squeeze
the ribcage; confine the force of the thrust to your hands.
- Repeat until object is expelled.
The Heimlich, according to WebMD,
“is an abdominal thrust that creates an artificial cough. It may be forceful
enough to clear the airway. The quick, upward thrust of the Heimlich maneuver forces the diaphragm
upward very quickly, making the chest cavity smaller. This has the effect of rapidly
compressing the lungs and forcing air out. The rush of air out will force out whatever
is causing the person to choke.”
When a victim is unconscious, or a rescuer cannot reach around the victim, try the
- Place the victim on his or her back.
Facing the victim, kneel astride the victim's hips. With one of your hands on top
of the other, place the heel of your bottom hand on the upper abdomen below the
rib cage and above the navel. Use your body weight to press into the victim's upper
abdomen with a quick upward thrust. Repeat until object is expelled. If the victim
has not recovered, proceed with CPR.
- The victim should see a physician
immediately after rescue.
- Don't slap the victim's back. (This
could make matters worse.)
The Heimlich Maneuver for Choking Infants
An infant or child can choke on food or toys that are small enough to enter the
windpipe. If a child has swallowed something but can breathe and is able to cough
or speak, it is best not to interfere because he or she will likely cough it out.
If a child cannot breathe, cough or speak, take immediate action. Call 911 for help,
and then start treatment. The method of treatment varies with the child's age. Follow
these steps to help a choking infant less than
1 year old:
- Place the baby's face down on your
lap with the head lower than the body.
- With the heel of your hand, hit
your baby high between the shoulder blades four times.
- If the object does not come out,
turn your baby over and compress (push on) the chest over the breast bone four times.
- If your child is still not breathing,
open the mouth to see if you can remove the object with your finger.
- Try mouth-to-mouth breathing, and
keep repeating this whole process until help arrives.
- For an older, larger child (older
than 1 year), use the Heimlich maneuver to try and remove a foreign object:
- Put the child on his back on the
floor or a table.
- Place the heel of one hand between
his belly button and the breast bone in the middle of his abdomen. Put your other
hand on top of the first hand and press inward and upward six to 10 times in rapid
- Check the child's mouth quickly
for the object, and try to remove it if it is visible.
- Try mouth-to-mouth breathing and
then repeat the Heimlich maneuver. Keep trying until help arrives.
- The Heimlich maneuver can be done
on a very large child in the standing or sitting position (from behind).
If the victim becomes unconscious:
victim on back, arms by side.
- Call out
"Help!", or if others respond, call 911.
tongue-jaw lift and finger sweep to try to remove the foreign body.
- Open airway
(head-tilt/chin-lift), and attempt rescue breathing.
- If unsuccessful,
give 6-10 sub-diaphragm abdominal thrusts (the Heimlich maneuver).
sequence: perform finger sweep, open the airway, attempt rescue breathing, perform
abdominal thrusts -- until successful.
- After obstruction
is removed, begin the ABC's of CPR if necessary.
- BE PERSISTENT.
Continue uninterrupted until obstruction is relieved or advanced life support is
available. When successful, have the victim examined by a physician as soon as possible.
If you are choking yourself, use the
above steps as an action guide, and try to get someone to assist you. Do not hesitate
to ask people nearby for help, if needed; staying alive trumps modesty and shyness.
(Never underestimate the ability of others to help; a recent story revealed that
a dog owner was saved from choking by the owner’s
pooch, who pounded on its owner’s chest until the piece of food was
dislodged. Good dog!)
For choking victims who are home and need to contact paramedics for attention, dial
911 if you can. If you are not near a phone, cannot get to a phone or cannot punch
in the numbers, you can still get immediate help if you are a member of Life Alert;
simply press your pendant to get in touch with live dispatchers within seconds.
They can send help to you, which will arrive in a matter of minutes. Life Alert
members who are not home while choking (or while facing other emergencies) can also
use a special one-button 911 cellphone (an optional Life Alert feature). If you
don’t currently have Life Alert, see below for links to information on this
The article above
is covered by a Creative Commons
Attribution 2.0 License.
The information provided is, to the best of our knowledge, reliable and accurate.
However, while Life Alert always strives
to provide true, precise and consistent information, we cannot guarantee 100 percent
accuracy. Readers are encouraged to review the original article, and use any resource
links provided to gather more information before drawing conclusions and making
Dr. Don Rose
writes books, papers and articles on computers, the Internet, AI, science and technology,
and issues related to seniors.
For more information
about Life Alert and its many services for
seniors and younger adults nationwide, please visit the following websites: