How to Perform First Aid for Choking: A Step-by-Step Guide

Choking is a serious emergency that can happen suddenly and without warning. Whether it’s an adult struggling with a piece of food, a child swallowing a small object, or an infant choking on milk or mucus, knowing how to respond can make the difference between life and death.

When an object gets stuck in the throat or windpipe, it blocks the flow of air, making it difficult or impossible to breathe. If not dealt with quickly, choking can lead to loss of consciousness and serious complications. This guide will help you understand the signs of choking, the correct first aid steps, and How to Perform First Aid for Choking.

What is Choking?

Choking occurs when something blocks the airway, preventing air from reaching the lungs. In mild cases, the person may be able to clear the obstruction by coughing. However, if the airway is fully blocked, it becomes a medical emergency that requires immediate action.

Common Causes of Choking

• Large pieces of food that are not chewed properly
• Hard sweets, nuts, or grapes
• Small objects like coins, buttons, or toys (common in children)
• Swallowing too quickly without enough chewing
• Drinking liquids too fast (more common in infants and elderly individuals)

Signs and Symptoms of Choking

It is important to recognise signs of choking and act quickly upon it. The signs may vary depending on whether the airway is partially or completely blocked.

Mild Choking

• The person can cough, talk, or make sounds
• They may have difficulty swallowing or breathing but can still take in some air
• They may appear panicked or uncomfortable

If someone has mild choking, encourage them to keep coughing forcefully. Coughing is the body’s natural way of clearing the airway, and it may dislodge the object without further intervention.

Severe Choking

• The person cannot cough, talk, or breathe
• They may hold their throat with both hands (the universal sign for choking)
• Their face may turn red or blue due to lack of oxygen
• Noisy or high-pitched breathing sounds may be heard
• If untreated, they may become unconscious

If someone shows these signs, they need urgent first aid to remove the obstruction.

First Aid for Choking: Adults and Children Over 1 Year Old

If a person is choking and unable to breathe, follow these steps:

Step 1: Encourage the Person to Cough

If they can still cough forcefully, tell them to continue as this may clear the obstruction on its own. Do not slap their back at this stage, as it may push the object deeper.

Step 2: Perform 5 Back Blows

If coughing is not effective:

1. Stand behind the choking person.
2. Support their chest with one hand and lean them slightly forward.
3. Using the heel of your other hand, give five strong blows between their shoulder blades.
4. After each blow, check if the object has come out.

If the obstruction remains, proceed to abdominal thrusts.

Step 3: Perform the Heimlich Manoeuvre (Abdominal Thrusts)

1. Stand behind the person and wrap your arms around their waist.
2. Make a fist with one hand and place it just above their navel.
3. Grab your fist with your other hand and pull inward and upward sharply.
4. Repeat up to five times, checking if the object is expelled.

If the person is still choking, alternate between five back blows and five abdominal thrusts until the airway is clear or emergency services arrive.

First Aid for Choking: Infants Under 1 Year Old

Babies require a different approach due to their delicate airways. If an infant is choking:

Step 1: Position the Baby Face Down

1. Sit down and hold the baby face down along your forearm.
2. Support their head and jaw with your hand.
3. Ensure their head is lower than their body.

Step 2: Give 5 Back Blows

1. Using the heel of your hand, deliver five firm but gentle back blows between the infant’s shoulder blades.
2. After each blow, check if the object is dislodged.

Step 3: Perform Chest Thrusts

1. If the object is still stuck, turn the baby onto their back.
2. Place two fingers in the centre of their chest, just below the nipple line.
3. Press down about 1.5 inches and release. Repeat five times.

Continue alternating between back blows and chest thrusts until the blockage is cleared or medical help arrives.

What to Do if the Choking Person Becomes Unconscious

If a choking person collapses and becomes unresponsive:

1. Call emergency services immediately.
2. Lay them flat on their back and check their mouth for visible obstructions. If you see something, try to remove it carefully.
3. If they are not breathing, start CPR:
• Perform 30 chest compressions in the centre of their chest.
• Give two rescue breaths by tilting the head back and breathing into their mouth.
• Continue cycles of compressions and breaths until help arrives.

When to Call Emergency Services

You should call 999 (or 112) immediately if:

• The person is unable to breathe or loses consciousness
• The obstruction is not removed after back blows and abdominal thrusts
• You are dealing with an infant who is choking

How to Perform the Heimlich Manoeuvre on Yourself

If you are alone and choking:

1. Call emergency services if possible.
2. Make a fist and place it just above your navel.
3. Grab your fist with your other hand and press inward and upward forcefully.
4. If you cannot clear the obstruction, lean over a hard surface like a chair or countertop and press your abdomen against it with forceful thrusts.

Preventing Choking Incidents

Although choking can happen suddenly, there are ways to reduce the risk.

Tips for Adults and Children

• Cut food into small pieces and chew slowly.
• Avoid talking or laughing while eating.
• Keep small objects, toys, and coins away from young children.
• Ensure children sit down while eating rather than walking or playing.

Tips for Infants and Toddlers

• Do not give hard or round foods like nuts, popcorn, or whole grapes to babies.
• Make sure toys are age-appropriate and do not have small parts.
• Always supervise infants while they are eating or drinking.

FAQs About Choking First Aid

What should I do if someone is choking and alone?
If possible, call emergency services and try to perform self-administered abdominal thrusts. Leaning over a chair or counter can help apply pressure to dislodge the object.

Is back slapping safe for adults?
Yes, back blows are recommended as a first step in choking first aid before moving to abdominal thrusts.

Can choking cause permanent damage?
If untreated for too long, choking can lead to oxygen deprivation, which may cause brain damage or death.

When should CPR be performed on a choking person?
CPR should be started if the person becomes unresponsive and is not breathing.

Final Thoughts

Choking can be frightening, but knowing how to respond can save a life. Whether you are helping an adult, child, or infant, acting quickly and confidently is crucial. Recognising the signs, using the right first aid techniques, and calling for help when necessary can make all the difference. Take the time to learn and practice these life-saving skills, as they may one day help you protect someone you love.