Choking

A blocked airway can kill within minutes. The response depends on whether the blockage is mild, where the person can still cough, or severe, where they cannot.

Mild blockage

If they can speak, cough or breathe, the blockage is mild. Encourage them to keep coughing; coughing generates far more airway pressure than anything you can do. Do not slap their back while they are coughing effectively, and stay with them until it clears.

Severe blockage in an adult or child over 1

If they cannot speak, cough or breathe, act immediately and have someone call 911. Give 5 firm back blows between the shoulder blades with the heel of your hand, with the person bent forward. If that fails, give 5 abdominal thrusts: stand behind them, place a fist just above the belly button, grasp it with your other hand and pull sharply inward and upward. Keep alternating 5 back blows and 5 abdominal thrusts until the object comes out or the person becomes unresponsive.

Babies under 1

Never use abdominal thrusts on a baby under 1. Support the baby face down along your forearm with the head lower than the body, and give 5 back blows between the shoulder blades. Then turn the baby face up and give 5 chest thrusts on the center of the breastbone, just below the nipple line. Alternate back blows and chest thrusts, and call 911. If the baby becomes unresponsive, start infant CPR.

Afterward

Anyone who has received abdominal thrusts should be checked by a doctor, because the technique can cause internal injury. Get medical advice too if a cough persists, or if they feel something is still stuck, since an object may remain lodged in the airway or esophagus.

At a glance

Term	Detail
Mild blockage	can speak, cough or breathe; encourage coughing
Severe blockage	cannot speak, cough or breathe; act immediately
Adult and child sequence	5 back blows, then 5 abdominal thrusts, alternating
Babies under 1	back blows and chest thrusts only; never abdominal thrusts
When to call 911	as soon as the blockage is severe
After abdominal thrusts	always get checked by a doctor
If they become unresponsive	start CPR

When to get help

Call 911 immediately for severe choking, and start CPR if the person becomes unresponsive. Always get a medical check after abdominal thrusts, even if the blockage cleared, because of the risk of internal injury. Get medical advice for a persistent cough or a feeling that something is still stuck. This page is a summary, not training; a hands-on first aid course is what builds the skill.

Where this comes from

• American Red Cross - Choking
• MedlinePlus - Choking - adult or child over 1 year
• MedlinePlus - Choking - infant under 1 year

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.