Choking first aid | What to do if someone is choking
What happens when someone is choking?
Choking occurs when something (an object, piece of food, or something else) gets lodged in a person’s airway. Choking can interrupt breathing and cause serious damage or even death if the object isn’t dislodged.
Mild choking
Depending on the size of the object, a person may be able to continue speaking and breathing, albeit at a lesser rate than normal.
Mild choking can often be cleared by coughing repeatedly, or with the assistance of ‘back blows’ from someone else.
Severe choking
Severe choking is far more dangerous. Signs of severe choking include being unable to cough, speak, and breathe, effectively.
The person will likely be incredibly agitated and distressed. If severe choking isn’t dealt with quickly, the casualty will become unconscious because of a lack of oxygen.
What can cause it?
- Chunks of poorly chewed food
- Bones in food
- Household items
- Bits of plastic
- Children’s toys
- Anaphylactic reactions
- Talking or laughing whilst eating
- Certain behavioural and medical conditions
What are the signs?
Depending on the severity of the situation, someone may provide visual or audible cues that they are choking on something. These include:
- Pointing to their throat
- Suddenly getting incredibly agitated or distressed
- Bluish skin due to a lack of oxygen
- Repeated coughing in an attempt to clear their throat
- Wheezing
- Clutching at the throat
- Drooling or spitting due to an inability to swallow what is left in their mouth
- Loss of consciousness
What to do if an adult is choking
1. Recognition
This step is to confirm that someone is indeed choking and that they require assistance.
Visual cues like those listed above often confirm this for you. If they don’t, clearly ask the person “are you choking?” before you start giving them black blows.
Before commencing back blows, encourage the casualty to let out a hard cough. If this proves ineffective or the casualty is unable to cough, you should progress and start administering back blows.
2. Back blows
Before you start, shout for someone to call 999 or call them yourself on speaker phone if you’re able.
Once you’ve done this, gently lean the casualty forward so they’re looking downward. This position means it’s more likely for the foreign body blocking the airway to dislodge itself when you start striking the back.
Next, use the heel of your hand and apply up to five sharp blows to the area between the shoulder blades. Remember that the aim of this is to use each blow to relieve the choking rather than to complete all five.
3. Abdominal thrusts
If the blockage has still not cleared, you’re going to move on to abdominal thrusts.
Stand behind the person who is choking and place both arms around them. Make a fist with one hand and place it just above the belly button (just below the ribs). Form a tight link with your other hand and sharply pull inwards and upwards.
Do this up to five times. Again, the aim is to relieve the choking with each thrust rather than to give all five.
4. Repeat steps 2 and 3
If the blockage still hasn’t cleared, repeat the application of back blows and abdominal thrusts. Double-check that someone has called 999 and that emergency services are on their way.
If the person becomes unconscious, prepare to administer CPR (details further down).
What to do if a baby is choking
The advice below applies to children under the age of one:
1. Back blows
Before you start, shout for someone to call 999 or call them yourself on speaker phone if you’re able.
To administer back blows to a baby, sit or kneel and lay the baby over your lap. Make sure their head is facing down and that you’re supporting their neck with your knee or other hand.
Give up to five sharp blows between the shoulder blades with the heel of your hand. As with an adult, the aim is to relieve the choking with each blow rather than to give all five blows.
2. Chest thrusts
If back blows don’t dislodge the blockage, start to administer chest thrusts. Giving these to a baby involves a slightly different technique than the one you’d use for an adult.
Turn the baby so they’re facing up. Lay them on your arm and lower their head (whilst supporting it) below the level of the chest.
Use two fingers to give up to five chest thrusts. These are like chest compressions, except chest thrusts are sharper and should be delivered at a slower rate.
The aim is to relieve the choking with each thrust rather than to give all five.
3. Repeat steps 1 and 2
If none of the above dislodges the blockage, repeat steps 1 and 2. Make sure someone has called 999 and that the emergency services are on their way.
If a baby becomes unconscious whilst choking, start CPR (details below).
What if the person becomes unconscious?
Adult
1. Send for a defibrillator and call 999
Before performing CPR, make sure you have sent for a defibrillator and someone has called 999 and requested an ambulance.
2. Start chest compressions
Place the heel of one hand against the centre of the chest (lower half of the sternum) and interlock fingers. Keep your arms straight and position yourself vertically above the casualty's chest.
Press down firmly on the chest. Compressions should aim to reach a depth of between 5 and 6cm. After each compression, release all the pressure on the chest. Repeat chest compressions at a rate of 100 to 120 per minute.
3. Give rescue breaths (if trained and confident)
If you are trained to do so, after 30 compressions, open the airway again and give 2 rescue breaths before returning to chest compressions.
4. If a defibrillator arrives…
Switch on the AED immediately and follow the voice prompts.
If advised, deliver an AED shock and make sure nobody else is touching the casualty. Immediately restart CPR at a ratio of 30:2.
If a shock is NOT advised, immediately restart CPR at a ratio of 30:2. Continue as directed by the voice/visual prompts.
Child
- Give five initial rescue breaths before starting chest compressions
- When you start chest compressions, do not compress the chest by more than 1/3 of its depth. This should not exceed 5cm
- Use one or two hands to apply pressure to the chest as you would do an adult.
Baby
- Give five initial rescue breaths before starting chest compressions
- When you start chest compressions, do not compress the chest by more than 1/3 of its depth. This should not exceed 4cm
- Use one or two fingers to apply pressure to the infant’s chest. Performing CPR on an infant requires a lot less pressure than an older child, so using your fingers should feel adequate.
What to do if you’re choking and you’re alone
If you start to choke and you’re on your own, the most important thing you do is to call 999 immediately. If you pass out or are unresponsive when questioned, the dispatcher will send someone to your location.
Leave the phone on speaker and follow the instructions below:
Try to cough up the object
The first thing to do is to try and dislodge whatever is obstructing your airway by coughing and clearing your throat. Do not drink anything to try and clear your throat, as this will make the blockage worse.
If coughing and clearing your throat doesn’t work, start chest thrusts on yourself.
Perform abdominal thrusts
This technique mimics the abdominal thrusts you would use on someone else if they were choking. Try to remain as calm as possible when doing this.
Start by making a fist with one hand and placing the thumb side between your belly button and rib cage. Place your other hand on top of your fist and push as hard as you can in a quick, upward motion into your abdomen. This action will put pressure on the bottom of your diaphragm which compresses your lungs to force air through your trachea.
When done correctly, this should generate enough force to dislodge and expel whatever it is that’s blocking your airway.
Always seek medical help afterwards
After successfully dislodging the obstruction, always get yourself checked by a medical professional just in case. You can do this by visiting A&E if you’re in serious pain, or at an urgent care centre.
This is important because chest thrusts can sometimes cause internal injury. A doctor may also want to assess your lungs to confirm there’s no foreign material in them, as this could lead to infection or other similar issues.
Last updated Wednesday 30 October 2024
First published on Wednesday 30 October 2024