Choking

What to do for adults and children over 1

1. Ask, “Are you choking?” If the person can cough hard or talk, let them keep coughing. Stay with them.
2. Call 911, or have someone call, if they can’t cough, speak, or breathe.
3. Give 5 back blows. Stand to the side and slightly behind them. Support their chest with one arm and lean them forward. Hit firmly between the shoulder blades with the heel of your hand, 5 times.
4. Give 5 abdominal thrusts. Stand behind them and wrap your arms around their waist. Make a fist and place it just above the belly button. Grab your fist with your other hand and pull in and up, hard and fast, 5 times.
5. Keep switching between 5 back blows and 5 thrusts until the object comes out or the person can breathe, cough, or talk.
6. If they pass out, lower them to the ground, call 911 if no one has, and start CPR. Each time you open the airway, look in the mouth. Remove an object only if you can see it.

If the person is pregnant or very large, give chest thrusts instead of abdominal thrusts: place your fist in the center of the breastbone and pull straight back.

If you are alone and choking, call 911. Then give yourself abdominal thrusts with your fist, or push your upper belly hard against the back of a chair or a counter.

For babies under 1 year

1. Call 911, or have someone call.
2. Give 5 back blows. Lay the baby face down along your forearm, resting on your thigh, with the head lower than the chest. Support the jaw with your hand. Give 5 firm blows between the shoulder blades with the heel of your other hand.
3. Give 5 chest thrusts. Turn the baby face up on your other arm, head lower than the chest. Using the heel of one hand, press down on the center of the chest, just below the nipple line, about 1½ inches, 5 times.
4. Keep switching between 5 back blows and 5 chest thrusts until the object comes out or the baby can cry, cough, or breathe.
5. If the baby stops responding, start infant CPR and keep going until help arrives.

Never give abdominal thrusts to a baby under 1 year.

Avoid

• Don’t sweep your finger blindly in the mouth. You could push the object deeper.
• Don’t slap the back of someone who is coughing hard. Coughing is the best way to clear the airway.

Prevention

• Cut food for young children into small pieces. Grapes, hot dogs, nuts, popcorn, hard candy, and chunks of meat are common choking hazards.
• Keep small objects, coins, button batteries, and balloons away from young children.