Choking: What the Evidence Actually Says
A complete obstruction kills within minutes, and the response differs by age in a way that matters.
Key takeaways
- Mild: can speak, cough or breathe — encourage coughing
- Severe: cannot speak, cough or breathe — act immediately
- Most useful single change: Encourage coughing while they still can.
- Commonest mistake: Abdominal thrusts on a baby under one.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
What it is
An obstructed airway, and what to do in the first seconds. It sits within Emergency Care. The table below gives the figures guidance actually works from.
The numbers, in one place
| Measure | Figure |
|---|---|
| Mild | can speak, cough or breathe — encourage coughing |
| Severe | cannot speak, cough or breathe — act immediately |
| Adults | up to 5 back blows, then up to 5 abdominal thrusts, alternating |
| Babies under 1 | back blows and chest thrusts only; never abdominal thrusts |
What helps
You do not have to do all of it, and you do not have to start today.
- Encourage coughing while they still can
- Lean them forward for back blows
- Call 999 as soon as the obstruction is severe
What to avoid
These come up often, and several of them sound like good ideas.
- Abdominal thrusts on a baby under one
- Slapping the back of someone who is coughing effectively
Where to go next
- Choking, Explained Without the Jargon
- Choking: The Practical To-Do List
- Choking — the reference entry
- Severe Bleeding: What the Evidence Actually Says
- Anaphylaxis: Emergency Response: What the Evidence Actually Says
When to speak to a doctor
Call 999 immediately for severe choking, and start CPR if the person becomes unresponsive. Always seek medical assessment after abdominal thrusts because of the risk of internal injury, and for a persistent cough or a sensation that something is still stuck.
Where this comes from
- Resuscitation Council UK — choking
- NHS — What to do if someone is choking
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, 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 999.
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