Choking: Help for Adults and Children

Choking happens fast and quietly. Knowing the difference between mild and severe choking tells you whether to wait or to act.

Mild or severe?

In mild choking, the person can still speak, cry, cough or breathe. Encourage them to keep coughing, because coughing is the most effective way to clear a blockage. Stay with them and do not leave them alone.

In severe choking, the person cannot speak, cry, cough or breathe. The NHS warns that without help they will eventually become unconscious. This is when you step in.

Helping a choking adult

1. Give up to 5 back blows. Stand behind the person and slightly to one side. Support their chest with one hand and lean them well forward. Hit firmly between the shoulder blades with the heel of your other hand, checking after each blow to see if the blockage has cleared.
2. Give up to 5 abdominal thrusts. Stand behind them and put your arms around their waist, bending them well forward. Clench one fist and place it just above the belly button, put your other hand on top, and pull sharply inwards and upwards. Check after each thrust.
3. Repeat the cycle of 5 back blows and 5 abdominal thrusts.
4. Get help. If the blockage has not come out, call Rescue 1122 where available, or go to the nearest hospital emergency department. Say clearly that the person is choking, and keep repeating the cycles until help arrives.

Helping a child over one year

1. Support the child leaning forward and give 5 back blows from behind, checking between each one.
2. If that does not work, stand or kneel behind the child, put your arms under their arms and around their upper tummy. Clench your fist and place it between the navel and the ribs, then pull sharply inwards and upwards, up to 5 times.
3. Do not press on the lower ribcage, as the NHS warns this can cause damage.
4. Keep alternating back blows and abdominal thrusts, and get emergency help if the object does not come out.

Helping a baby under one year

1. Back blows. Lay the baby face down along your thigh or forearm, supporting the head. Give up to 5 sharp back blows with the heel of your hand, in the middle of the back between the shoulder blades. Check between each blow.
2. Chest thrusts. Turn the baby face up along the length of your thighs, feet closest to you and head furthest away. Place 2 fingers in the middle of the chest, just below the nipple line, and give up to 5 sharp chest thrusts. Check between each one.
3. Alternate the two, and get emergency help if the blockage does not clear.

What NOT to do

• Never give abdominal thrusts to a baby under one year. Babies get back blows and chest thrusts only.
• Do not poke blindly or repeatedly with your fingers. The NHS warns that you can push the object further in and make it harder to remove.
• Do not interrupt an effective cough. If the person is coughing strongly, let them cough.
• Do not press on the lower ribcage when helping a child.
• Do not skip the medical check afterwards. The NHS says a choking person should always be seen by a healthcare professional, even if the object came out, because part of it may be left behind or the thrusts may have caused injury.

When to get emergency help

Call Rescue 1122 where available, or go to the nearest hospital emergency department if:

• The person cannot speak, cough or breathe
• The blockage has not come out after back blows and thrusts
• The person becomes unconscious or stops breathing normally, in which case start CPR straight away
• The person is still coughing, drooling, wheezing or struggling to swallow after the object appears to have cleared

Anyone who has needed abdominal thrusts should be checked by a doctor afterwards.