Choking occurs when a foreign item becomes stuck in the windpipe or neck and blocks the airway. In adults, food is usually the cause. Children often ingest tiny items. The brain loses oxygen when someone chokes, so emergency care should be administered as soon as possible.

The hands clasped around the neck are a recognized symptom of choking. Look for these signs if the individual doesn’t have the above symptoms:

  • Unable to speak
  • Loud breathing or difficulty breathing
  • Breathing noises that are squeaky
  • Coughing that might be gentle or vigorous
  • Becoming blue or sallow in the skin, lips, and nails
  • Flushed skin that afterward becomes blue or gray.
  • Loss of consciousness

If the individual can cough vigorously, they should continue to cough. The American Red Cross advises using a “five-and-five” method of administering first aid if the individual is choking and unable to speak, scream or laugh loudly.

Give the choking person 5 back blows. 

Approach an adult who is choking from behind and to the side. For a child, kneel down behind. To provide support, cross one arm over the person’s chest. 

The upper body should be parallel to the ground when the individual is bent over at the waist. Use the heel of your palm to hit the person’s back five times in succession between the shoulder blades.

Perform five abdominal thrusts. Five abdominal thrusts should be made (this is called the Heimlich maneuver).

Until the obstruction is removed, alternate between five blows and five thrusts.

The American Heart Association only teaches abdominal thrust techniques; it does not teach the back blow method. If you haven’t mastered the skill, it’s OK not to utilize back blows. Both strategies are valid.

To conduct the Heimlich maneuver (abdominal thrusts) on another person:

Place yourself in their back. For balance, place one foot just in front of the other. Arm yourself at the waist. 

Lean the individual gently forward. If a child is choking, kneel down behind the child.

A fist should be made. It should be placed just above the person’s navel.

Use the other hand to hold the fist. As though attempting to hoist the individual up, quickly push upward while pressing firmly into the abdomen.

Up to 6 – 10 abdominal thrusts should be performed to free the obstruction.

Before dialing your local emergency number for assistance, conduct back blows and abdominal thrusts if you’re the only rescuer. While you provide first aid, have a companion call for assistance if one is available.

Perform routine cardiopulmonary resuscitation (CPR) with chest compressions and rescue breaths if the victim falls unconscious.


To do the Heimlich maneuver (abdominal thrusts) on yourself:

First, call your local emergency number right away if you’re alone and choking. Then, even if you won’t be able to successfully strike yourself in the back, you may still move the object using abdominal thrusts.

Make a fist and place it just over the navel.

With the other hand, hold your fist while stooping over a hard surface, such as a chair or a countertop.

Fist-pump upward and inward.

To clear the airway of an obese or pregnant person:

Place your hands at the base of the breastbone, just above the junction of the lowest ribs, somewhat higher than with a standard Heimlich maneuver.

Press firmly into the chest with a sharp push like you would while doing the Heimlich maneuver.

Continue until the food or other obstruction is removed. Take the following actions if the subject loses consciousness.

To clear an unconscious person’s airway

With arms at the sides, lower the individual to the ground on their back.

Clear up the airway. Put a finger into the mouth and remove the obstruction if a blockage is apparent at the back of the throat or high in the throat. 

If you are unable to see the thing, don’t do a finger sweep. Avoid pushing the food or item farther into the airway, which is easy to do with small toddlers.

If the item is still stuck and the individual doesn’t react after the previous steps, start CPR. The item might be moved by the chest compressions performed in CPR. Rechecking the mouth from time to time is important.

To clear an infant’s airway who is choking and is under 1 year old

Sit down and place your forearm on your thigh while holding the baby face down on your forearm. Place the infant’s head lower than the trunk and support its neck and head with one hand. 

Use the heel of your palm to softly but forcefully thud the baby five times in the centre of the back. The blocked item should be released by gravity and the back blows. To prevent striking the newborn in the back of the head, keep your fingers pointing upward.

If the baby is still not breathing, turn him or her face up on your forearm, with the head lower than the trunk. Give the baby five fast chest compressions with your fingers positioned in the middle of the baby’s breastbone. Between each compression, let the chest rise once again and push down about 1 1/2 inches.

If breathing doesn’t start again, repeat the back strikes and chest thrusts. Request immediate medical assistance.

If one of these methods succeeds in opening the airway but the child still isn’t breathing, start newborn CPR.

Give just abdominal thrusts if the child is cognizant and older than 1 year. To protect the ribs and internal organs, take care not to employ too much power.

Learn the Heimlich manoeuvre and CPR in a recognized first-aid training school to equip yourself for these scenarios.

References:

https://raisingchildren.net.au/babies/safety/choking-strangulation/choking-first-aid-pictures

https://www.mayoclinic.org/first-aid/first-aid-choking/basics/art-20056637