Good choking first aid starts with one distinction: a person who can cough forcefully should be encouraged to keep coughing, while someone who cannot breathe, speak or cough effectively needs urgent help. The steps differ for adults, children over 1 year and babies under 1.
Call your local emergency number for severe choking. If someone is with you, ask them to call while you help; if you are alone, use speakerphone when possible and follow the dispatcher’s directions.
Choking First Aid: Tell An Effective Cough From A Blockage
A strong cough, clear speech and the ability to breathe suggest that air is still moving. Stay with the person and encourage them to cough. Don’t give back blows or thrusts while the cough is effective.
Act if the cough is weak or silent, or the person cannot speak or breathe. They may clutch their throat, make little or no sound, become blue around the lips, or grow limp. A choking baby may be unable to cry or may make a weak, high-pitched sound. Don’t wait for every sign to appear.
Adults And Children Over 1 Year
For a severe blockage, call emergency services and begin first aid. Have the person lean forward. Give up to 5 sharp back blows between the shoulder blades with the heel of your hand, checking after each one to see if the blockage has cleared.
If the person is still choking, give up to 5 thrusts, then repeat the sequence until the blockage clears or help arrives. The type of thrust varies by local guidance: many protocols recommend abdominal thrusts for adults and children over 1, while Australian guidance uses chest thrusts. For abdominal thrusts, stand behind the person, place a fist above the navel and below the ribs, grasp it with your other hand, and pull sharply inward and upward. Follow your local first-aid training and the emergency dispatcher’s instructions.
In the UK, NHS guidance uses back blows followed by abdominal thrusts for children over 1. Australian guidance uses back blows followed by chest thrusts for adults and children. Guidelines differ, so knowing the approach taught where you live can help you act without hesitation.
Infant Choking: Use Back Blows And Chest Thrusts
For a baby under 1 year who cannot cough, cry or breathe effectively, call emergency services immediately. Keep the baby’s head lower than their body and support the head and neck. Lay the baby face down along your forearm or thigh and give up to 5 sharp back blows between the shoulder blades, checking after each one.
If the blockage remains, turn the baby face up while keeping the head supported. Give up to 5 chest thrusts with two fingers on the lower half of the breastbone, checking after each thrust. Repeat the back blows and chest thrusts until the blockage clears or help arrives. Never use abdominal thrusts on a baby. Remove an object from the mouth only if you can see it and reach it easily—never sweep blindly with a finger.
If The Person Becomes Unresponsive
If the person collapses or becomes unresponsive, call emergency services if that has not already been done and start CPR. Put the phone on speaker so you can follow dispatcher instructions. If you are trained, use age-appropriate CPR; when opening the mouth, remove an object only if it is clearly visible. Don’t delay CPR to search blindly for an obstruction.
After The Blockage Clears
Getting the object out does not always mean the airway is clear or that no injury occurred. Seek urgent care for ongoing difficulty breathing, wheezing, coughing, voice changes or blood. Arrange medical assessment after a significant choking episode, particularly if thrusts were used or the person is a baby or child. A clinician can check for a retained object or injury. If symptoms persist or worsen, call emergency services.
Reading instructions is not a substitute for practice. A hands-on first-aid course can help you learn the techniques and the protocol used in your area.
