If someone is choking and cannot clear their airway by coughing, call for emergency medical help (ambulance) immediately, then perform a combination of back blows and abdominal thrusts (Heimlich maneuver) until help arrives or the object is dislodged.
Here's a breakdown of the steps to take when someone is choking:
Recognizing the Signs of Choking
Before intervening, it's crucial to identify if someone is actually choking. Key indicators include:
- Inability to talk
- Difficulty breathing or noisy breathing
- Inability to cough forcefully
- Bluish skin color (cyanosis)
- Loss of consciousness
Steps to Unblock Choking (Conscious Adult or Child over 1 year old)
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Ask: "Are you choking?" If they can cough or speak, encourage them to continue coughing forcefully. Do not interfere if they are effectively coughing.
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Call for Help: If the person cannot cough, speak, or breathe, immediately call for emergency medical services (ambulance). If someone else is present, have them call while you begin assisting the choking person.
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Back Blows:
- Stand slightly behind the person and to one side.
- Support their chest with one hand and lean them forward.
- Deliver five firm back blows between their shoulder blades with the heel of your other hand.
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Abdominal Thrusts (Heimlich Maneuver):
- If the back blows are ineffective, perform abdominal thrusts.
- Stand behind the person. Place your arms around their waist.
- Make a fist with one hand and place the thumb side against the middle of their abdomen, slightly above the navel and below the rib cage.
- Grasp your fist with your other hand and give five quick, upward and inward thrusts.
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Alternate Back Blows and Abdominal Thrusts: Continue alternating five back blows with five abdominal thrusts until the object is dislodged or the person becomes unconscious.
If the Person Becomes Unconscious:
- Carefully lower the person to the ground.
- Call for emergency medical services if you haven't already.
- Begin chest compressions (similar to CPR). Each time you deliver a compression, look inside the mouth for the obstructing object. If you see it, carefully remove it.
- Continue chest compressions until help arrives.
- If possible, give two rescue breaths after every 30 compressions.
Unblocking Choking in Infants (Under 1 Year Old)
The technique for infants is different:
- Support the infant face down: Hold the infant face down along your forearm, supporting their jaw and chest. Rest your forearm on your thigh.
- Back Blows: Deliver five firm back blows between the infant's shoulder blades using the heel of your hand.
- Chest Thrusts: If the object is not dislodged, turn the infant face up, supporting their head and neck. Place two fingers in the center of the infant's chest, just below the nipple line. Give five quick chest thrusts, compressing the chest about 1.5 inches.
- Repeat: Continue alternating back blows and chest thrusts until the object is dislodged or the infant becomes unconscious. If the infant becomes unresponsive, start infant CPR.
Important Considerations:
- Training: Taking a certified first aid and CPR course is highly recommended.
- Alone: If you are choking and alone, you can perform abdominal thrusts on yourself by using a firm object like a chair or countertop to thrust against.
- Pregnant Women or Obese Individuals: Perform chest thrusts instead of abdominal thrusts. Wrap your arms under the person's armpits and place the thumb side of your fist on the center of their breastbone. Grasp your fist with your other hand and give a quick, inward thrust.
Choking is a life-threatening emergency that requires immediate action. Knowing the proper techniques can save a life.
